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目的探讨中孕中期(24~28周)胎儿动脉导管参考值范围及其对胎儿动脉导管依赖型先天性心脏病的诊断价值。方法 9026例进行产前筛查的孕妇,中孕中期8091例,同时进行胎儿心脏超声,测量动脉导管(DA)内径,统计各孕周DA内径参考值范围,分析动脉导管依赖型先天性心脏病与DA内径参考值的关系。结果中孕中期产前筛查的孕周内完成胎儿心脏超声检查共7931例观测到DA,显示率为98.0%。胎儿DA内径值呈正态分布,且DA内径值随孕周增长而增宽。24~28周胎龄胎儿DA内径值分别为(2.43±0.27)mm、(2.50±0.28)mm、(2.58±0.27)mm、(2.71±0.31)mm、(2.99±0.29)mm。DA增宽2例为完全型房室隔缺损、右室双出口和主动脉弓缩窄各1例;DA缩窄3例为三尖瓣下移畸形、法洛四联症以及完全性大动脉转位并肺动脉狭窄各1例。结论中孕中期能够观察到胎儿DA,并能进行管径测量,DA内径参考值的建立对早期发现DA异常及DA相关疾病有所帮助。
Objective To investigate the reference range of fetal ductus arteriosus in mid-second trimester (24-28 weeks) and its diagnostic value in fetal ductus arteriosus-dependent congenital heart disease. Methods Nine hundred and ninety-two pregnant women with prenatal screening and 8091 middle-trimester pregnant women were enrolled in this study. Fetal heart ultrasound was performed at the same time. The diameter of arterial catheter (DA) was measured. The reference range of DA inner diameter was calculated. The incidence of arterial catheter-dependent congenital heart disease And DA diameter reference value. Results In the second trimester, 7931 fetuses underwent echocardiography within the gestational weeks of prenatal screening. DA was observed, showing a rate of 98.0%. Fetal DA diameter values were normal distribution, and DA diameter values with gestational age increased. The fetal DA values of (2.43 ± 0.27) mm, (2.50 ± 0.28) mm, (2.58 ± 0.27) mm, (2.71 ± 0.31) mm, (2.99 ± 0.29) mm, respectively, DA widened in 2 cases of complete atrioventricular septal defect, right ventricular double outlet and aortic arch narrowed in 1 case; DA narrowed in 3 cases of tricuspid regurgitation, tetralogy of Fallot and complete aortic transposition Pulmonary artery stenosis in 1 case. Conclusion The fetus DA can be observed in the middle of second trimester, and the diameter of the fetus can be measured. The establishment of reference value of DA can be helpful in the early detection of DA abnormalities and DA related diseases.