Prenatal echocardiographic characteristics and prognosis of fetal pulmonary artery sling: analysis of 13 cases

Q4 Medicine 中华围产医学杂志 Pub Date : 2019-10-16 DOI:10.3760/CMA.J.ISSN.1007-9408.2019.10.012

Siyu Wang, X. Gu, Jiancheng Han, Ying Zhao, Xiaowei Liu, Ye Zhang, Lin Sun, Yong Guo

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Abstract

Objective To analyze the echocardiographic features and prognosis of fetal pulmonary artery sling (PAS). Methods In this retrospective study, clinical information of 13 PAS cases diagnosed by fetal echocardiography in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2018 were collected. Echocardiographic characteristics and complications of intracardiac and extracardiac malformations were summarized. Their outcomes were also analyzed. Results (1) Two out of the 13 pregnant women continued their pregnancies until delivery, while the other 11 terminated the pregnancies. One neonate received surgery in another hospital after birth and was followed up to one year old with normal growth and development. The other infant was lost to follow up after birth. (2) Among the 13 cases, 12 were complete PAS and one (case 13) was partial PAS. Nine cases were complicated by other intracardiac malformations and five by extracardiac malformations. (3) Pulmonary artery development: Echocardiographic data of ten cases (the other three cases were excluded due to absence of detailed echocardiographic information) revealed that one fetus had tetralogy of Fallot with the diameter of pulmonary valve under normal value, while the pulmonary valve diameters of the other nine cases were all within the normal range. The inner diameter of the left and the right pulmonary artery that below the normal values were observed in four and two cases, respectively. One case showed absent distal end of right pulmonary artery with right pulmonary dysplasia, but the normal inner diameter at the beginning of right pulmonary artery. Conclusions Fetal PAS is more likely to be complicated by persistent left superior vena cava (PLSVC) and ventricular septal defect (VSD) as well as left and right pulmonary artery stenosis. The prognosis of PAS may be improved if operation is performed after birth, but further studies are needed. Key words: Pulmonary artery; Congenital abnormalities; Ultrasonography, prenatal; Echocardiography; Prognosis

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13例胎儿肺动脉悬吊的超声心动图特征及预后分析

目的分析胎儿肺动脉悬带（PAS）的超声心动图特征及预后。方法收集首都医科大学附属北京安贞医院2016年1月至2018年12月13例经胎儿超声心动图诊断为PAS的临床资料。总结了心内外畸形的超声心动图特征和并发症。他们的结果也进行了分析。结果（1）13名孕妇中有2名继续妊娠直至分娩，其余11名终止妊娠。一名新生儿出生后在另一家医院接受了手术，随访至一岁，生长发育正常。另一名婴儿在出生后失去了随访机会。（2） 13例中，12例为完全PAS，1例（病例13）为部分PAS。9例并发其他心内畸形，5例并发心外畸形。（3）肺动脉发育：10例（其他3例因缺乏详细的超声心动图信息而被排除在外）的超声心动描记图数据显示，1例胎儿患有法洛四联症，肺动脉瓣直径低于正常值，而其他9例的肺动脉瓣径均在正常范围内。左、右肺动脉内径分别低于正常值4例和2例。1例右肺动脉远端缺失伴右肺发育不良，但右肺动脉起始处内径正常。结论胎儿PAS易并发持续性左上腔静脉（PLSVC）、室间隔缺损（VSD）及左右肺动脉狭窄。如果在出生后进行手术，PAS的预后可能会得到改善，但还需要进一步的研究。关键词：肺动脉；先天性异常；产前超声检查；超声心动图；预后

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来源期刊

中华围产医学杂志 Medicine-Obstetrics and Gynecology

CiteScore

0.70

自引率

0.00%

发文量

4446

期刊介绍： Chinese Journal of Perinatal Medicine was founded in May 1998. It is one of the journals of the Chinese Medical Association, which is supervised by the China Association for Science and Technology, sponsored by the Chinese Medical Association, and hosted by Peking University First Hospital. Perinatal medicine is a new discipline jointly studied by obstetrics and neonatology. The purpose of this journal is to "prenatal and postnatal care, improve the quality of the newborn population, and ensure the safety and health of mothers and infants". It reflects the new theories, new technologies, and new progress in perinatal medicine in related disciplines such as basic, clinical and preventive medicine, genetics, and sociology. It aims to provide a window and platform for academic exchanges, information transmission, and understanding of the development trends of domestic and foreign perinatal medicine for the majority of perinatal medicine workers in my country.