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目的探讨胎儿动脉导管收缩或早闭的早期临床诊断及处理。方法报道胎儿动脉导管收缩导致右心功能衰竭1例,并收集近年文献进行复习,总结该疾病的临床表现、诊断、处理及患儿预后。结果收集近年来12篇胎儿动脉导管收缩或早闭的文献,共33例,其中5例母亲孕期有使用前列腺素合成酶抑制剂病史,胎儿心脏彩色超声均提示动脉导管不同程度的收缩或关闭,部分伴有右心室、右心房扩大,右心室肥大,三尖瓣或肺动脉瓣反流,肺动脉扩张及胎儿水肿。5例死亡,其余病例均存活,绝大部分病例预后良好,2例头颅MRI提示缺氧缺血性脑病(HIE)。结论母亲无使用前列腺素合成酶抑制剂史的胎儿亦可以发生动脉导管收缩或早闭,产前超声对该疾病的诊断具有重要意义,早期诊断并适时终止妊娠可以挽救患儿生命,大部分患儿预后良好。
Objective To investigate the early clinical diagnosis and treatment of fetal ductus contractions or early closure. Methods One case of right heart failure caused by contraction of fetal ductus arteriosus was reported and the recent literature was collected to review and summarize the clinical manifestations, diagnosis, treatment and prognosis of the disease. Results A total of 33 cases of contraction or early closure of fetal ductus arteriosus were collected in recent years. Among them, 5 cases had a history of using prostaglandin synthase inhibitor during pregnancy and fetal heart color ultrasound showed different degrees of contraction or closure of the ductus arteriosus. Part of the right ventricle associated with right atrial enlargement, right ventricular hypertrophy, tricuspid or pulmonary valve regurgitation, pulmonary artery dilatation and fetal edema. 5 cases died, the remaining cases were alive, the prognosis of most cases is good, 2 cases of cranial MRI prompted hypoxic-ischemic encephalopathy (HIE). Conclusion The fetus with no history of prostaglandin synthase inhibitor in the mother can also contract or early closure of the ductus arteriosus. Prenatal ultrasound is of great significance in the diagnosis of the disease. Early diagnosis and timely termination of pregnancy can save children’s lives. Most of the patients Prognosis is good.