[1]吴秋梅,郭洁,郭珊,等.胎儿大动脉转位产前超声诊断及预后分析[J].福建医药杂志,2023,45(03):5-8.
　WU Qiumei,GUO Jie,GUO Shan,et al.Prenatal ultrasound diangnosis and prognosis analysis of fetal transposition of great arteries[J].FUJIAN MEDICAL JOURNAL,2023,45(03):5-8.
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胎儿大动脉转位产前超声诊断及预后分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期数:
2023年03期
页码:
5-8
栏目:
临床研究
出版日期:
2023-06-15

文章信息/Info

Title:
Prenatal ultrasound diangnosis and prognosis analysis of fetal transposition of great arteries
文章编号:
1002-2600(2023)03-0005-04
作者:
吴秋梅; 郭洁; 郭珊; 凌文; 李尚青; 刘敏; 翁宗杰1
福建省妇幼保健院 福建医科大学妇儿临床医学院(福州 350001)
Author(s):
WU Qiumei;  GUO Jie;  GUO Shan;  LING Wen;  LI Shangqing;  LIU Min;  WENG Zongjie
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian 350001, China
关键词:
大动脉转位;  产前超声;  预后;  随访管理
Keywords:
transposition of great arteries;  prenatal ultrasound;  prognosis;  follow-up management
分类号:
R445.1; R714.5
文献标志码:
B
摘要:
目的 探讨产前超声在胎儿大动脉转位(TGA)诊断中的应用价值并分析其预后情况。方法 回顾性分析我院2016年8月至2021年9月产前诊断的49例胎儿TGA超声数据及相关病历资料,分析胎儿TGA产前超声诊断情况、随访管理情况及预后。结果 49例胎儿TGA中,完全型大动脉转位(D-TGA)46例(93.9%),矫正型大动脉转位(C-TGA)3例(6.1%)。46例D-TGA中,2例早孕期诊断,39例中孕期诊断,5例晚孕期转诊至我院诊断; 40例(87.0%)选择引产,6例(13.0%)继续妊娠至分娩,其中5例(10.9%)出生后接受手术,4例(8.7%)手术治疗患儿随访至今预后良好。3例C-TGA中,2例早孕期诊断,均引产; 1例中孕期诊断,继续妊娠并分娩,出生后无处理,目前情况良好。结论 产前超声能够对TGA做出较为准确的诊断; 对于继续妊娠的孕妇,产前超声随访管理、围产期制定个体化预案,分娩时多学科联合救治,有利于获得良好预后。
Abstract:
Objective To investigate the value of prenatal ultrasound in the diagnosis of fetal transposition of the great arteries(TGA), and to analyze the prognosis of fetal TGA. Methods The ultrasound data and medical information of the fetal TGA cases who were diagnosed from August 2016 to September 2021 in Fujian Maternity and Child Health Hospital were retrospectively selected to analyze the characteristic of prenatal diagnosis, follow-up management, and prognosis of TGA. Results A total of 49 fetuses with TGA were included in the study, including 46(93.9%)with complete transposition of the great arteries(D-TGA)and 3(6.1%)with corrected transposition of the great arteries(C-TGA). Of the 46 D-TGA cases, 2 cases were diagnosed in early pregnancy, 39 cases were detected in the second trimester, and 5 cases were referred to our hospital for diagnosis in third trimester. 40(87.0%)of 46 D-TGA were induced, 6 cases(13.0%)continued pregnancy, 5 cases(10.9%)underwent surgery after birth, and 4 cases(8.7%)had a good prognosis after surgery to date. Of the 3 C-TGA cases, 2 cases were diagnosed in early pregnancy and eventually induced,1 case was detected in the second trimester and continued with pregnancy until delivery. Conclusion Prenatal ultrasound can be greatly useful in the diagnosis of fetal TGA. For pregnant women who continue with the pregnancy, prenatal ultrasound follow-up management, perinatal development of individualized plans, and multidisciplinary joint treatment during delivery are conducive to good prognosis.

参考文献/References:

[1] Ekiz A, Kaya B, Bornaun H, et al. Flecainide as first-line treatment for fetal supraventricular tachycardia[J]. Journal of Maternal-Fetal & Neonatal Medicine,2018,31(4):407-412.
[2] Miyoshi T, Maeno Y, Sago H, et al. Antenatal antiarrhythmic treatment for fetal tachyarrhythmias: a study protocol for a prospective multicentre trial[J]. BMJ Open,2017,7(8):e016597.
[3] Anderson B R, Ciarleglio A J, Hayes D A, et al. Earlier arterial switch operation improves outcomes and reduces costs for neonates with transposition of the great arteries[J]. Journal of the American College of Cardiology,2014,63(5):481-487.
[4] Vorisek C N, Enzensberger C, Willomeit S, et al. Prenatal Diagnosis and Outcome of Congenital Corrected Transposition of the Great Arteries- A Multicenter Report of 69 Cases[J]. Ultraschall in der Medizin,2021,42(3):291-296.
[5] Qiu X, Weng Z, Liu M, et al. Prenatal diagnosis and pregnancy outcomes of 1492 fetuses with congenital heart disease: role of multidisciplinary-joint consultation in prenatal diagnosis[J]. Scientific Reports,2020,10(1):7564.
[6] Bertagna F, Rakza T, Vaksmann G, et al. Transposition of the great arteries: factors influencing prenatal diagnosis[J]. Prenatal Diagnosis,2014,34(6):534-537.
[7] Lammer E J, Chak J S, Iovannisci D M, et al. Chromosomal abnormalities among children born with conotruncal cardiac defects[J]. Birth Defects Research Part A: Clinical and Molecular Teratology,2009,85(1):30-35.
[8] Van Velzen C L, Haak M C, Reijnders G, et al. Prenatal detection of transposition of the great arteries reduces mortality and morbidity[J]. Ultrasound in obstetrics & gynecology,2015,45(3):320-325.
[9] Day T G, Woodgate T, Knee O, et al. Postnatal outcome following prenatal diagnosis of discordant atrioventricular and ventriculoarterial connections[J]. Pediatric cardiology,2019,40(7):1509-1515.
[10] Santens B, Van De Bruaene A, De Meester P, et al. Outcome of arterial switch operation for transposition of the great arteries. A 35-year follow-up study[J]. International journal of cardiology,2020,316:94-100.
[11] Donofrio M T, Skurow-Todd K, Berger J T, et al. Risk-stratified postnatal care of newborns with congenital heart disease determined by fetal echocardiography[J]. Journal of the American Society of Echocardiography,2015,28(11):1339-1349.

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备注/Memo

备注/Memo:
基金项目:福建省自然科学基金资助项目(2021J01420)
1 通信作者,Email:wengzongjie1984@fjmu.edu.cn
更新日期/Last Update: 2023-06-15