目的探讨产前超声诊断胎儿单纯动脉导管提前收缩或早闭的临床价值。方法回顾性分析湖南省妇幼保健院近两年来经产前超声检查并产后证实的胎儿动脉导管提前收缩5例和早闭1例的超声心动图表现、临床处理方案及胎儿预后。结果 6例胎儿(动脉导管早闭1例和动脉导管狭窄5例)均处于妊娠晚期。该组病例中,6例胎儿的房室连接、大血管起源、瓣膜附着点及活动等未发现异常声像,6例胎儿均未探及明显心外各个器官系统的结构异常。5例动脉导管提前收缩的胎儿超声心动图提示动脉导管起始段有不同程度的狭窄(最窄处内径0.26~0.30 cm,收缩期最高血流速度>2.0 m/s),狭窄后的主干部分扩张,动脉导管形态扭曲。1例提示动脉导管几乎关闭,内未探及彩色多普勒血流信号,仅见少量低速能量多普勒血流信号;6例均伴有右心扩大,不同程度的三尖瓣及肺动脉瓣反流,4例伴肺动脉扩张,1例伴少量心包积液,6例均出生,产后随访1~3个月,所有患儿预后良好,只有1例胎儿母亲孕期有使用消炎痛病史。结论产前超声对该疾病具有较高的诊断价值,早期诊断及密切随访可以为临床提供重要的信息,有助于胎儿的咨询及合理处理,提高患儿成活率。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提前收缩或早闭,动脉导管提前收缩或早闭在妊娠晚期多见。 Objective To investigate the clinical value of prenatal ultrasound in diagnosing premature contractions or early closure of fetal ductus arteriosus. Methods We retrospectively analyzed the echocardiographic manifestations, clinical management plans and fetal prognosis of 5 cases of fetal ductus contractions and 1 case of early closure confirmed by prenatal ultrasound and postnatal ultrasound in MCH hospital of Hunan province in recent two years. Results 6 fetuses (1 case of early ductus arteriosus and 5 cases of patent ductus arteriosus) were in the third trimester of pregnancy. In this group of cases, no abnormal sonography was found in 6 cases of fetal atrioventricular connection, major vessel origin, valvular attachment point and activity. No abnormalities were found in all the organ systems in 6 cases. Fetal echocardiography in 5 cases with premature contractions of the ductus arteriosus suggested that the initial section of the ductus arteriosus had different degrees of stenosis (the narrowest internal diameter was 0.26-0.30 cm, the highest systolic blood flow velocity was> 2.0 m / s), and the stenosed trunk Dilatation, ductus arteriosus distorted. One case showed that the patent ductus arteriosus was almost closed, the color Doppler flow signal was not detected and only a small amount of low-speed Doppler flow signal was seen. Six cases were accompanied by enlarged right ventricle, tricuspid valve and pulmonary valve flap Flow, 4 cases with pulmonary artery dilatation, 1 case with a small amount of pericardial effusion, 6 cases were born, postpartum follow-up of 1 to 3 months, all children with good prognosis, only 1 fetus during pregnancy with indomethacin history. Conclusion Prenatal ultrasound has a high diagnostic value for the disease. Early diagnosis and close follow - up can provide important information for clinicians, which helps to consult and manage the fetus and improve the survival rate of the children. Mothers with no history of prostaglandin synthase inhibitors may also develop premature or early patent ductus arteriosus contractions or early closure of the patent ductus arteriosus more common in late pregnancy.