Ouantitative Estimation Of The Relationship Between Foramen Ovale-related Parameters And The Hypoplastic Left Heart Syndrome Using Fetal Echocardiography

Evaluation of the fetal heart constitutes one of the critical areas of the prenatal diagnosis,fetal echocardiography acts as a window to the developing heart,With the fetal echocardiography in the application of the fetal cardiac examination increasingly sophisticated,it will provide a new means for prenatal ultrasound diagnosis of fetal complex congenital heart disease,and has very important significance to improve the quality of perinatal survival and quality of the population.This study was therefore designed to measure the 18-40 weeks fetal foramen ovale-related parameters by echocardiography,and to set up the reference range of normal fetal foramen foramen ovale-related parameters in different gestational age,and to further explore the relationship between foramen ovale-related parameters and fetal hypoplastic left heart syndrome.1 Study population and Methods1.1 Study populationFrom June 2008 to February 2009,fetal echocardiographic examinations were performed in 206 consecutive pregnant women,(pregnant women age 29.8±14.8 years, range 18-42 years,gestational age 31±5.1weeks,range 18-40 weeks).Three fetuses with poor Doppler imaging quality,five with complete atrioventricular septal defect, two with single atrium,three with single ventricle,five with right ventricular dysplasia syndrome were excluded.1.2 Methods188 cases of fetal foramen ovale-related parameters were obtained,to analyze its change with the gestational age,and study the relationship between foramen ovale-related parameters and fetuses with left ventricular dysplasia.2 Results(1) We found that fetal foramen ovale valve flap diameter and the relevant parameters change with the gestational age,like other organs are gradually growing.(2) Normal fetal foramen ovale valve flap diameter was similar to the aortic diameter,we found that normal fetuses had a foramen ovale valve flap diameter/aortic root size ratio of(0.93±0.19)(mean±SD),fetuses with left ventricular dysplasia syndrome had a foramen ovale valve flap diameter/aortic root size ratio larger than normal(1.19±0.28)(mean±SD),we also found that normal fetuses had a foramen ovale Valve flap diameter/atrial septum size ratio of(0.36±0.07)(mean±SD),fetuses with left ventricular dysplasia syndrome had a foramen ovale valve flap diameter/atrial septum size ratio smaller than normal(0.27±0.06)(mean±SD).3 ConclusionForamen ovale-related parameters change with the gestational age,it could be used to assess fetal growth status,as compared with normal fetuses of gestational age ranged 18-40 weeks,we found that foramen ovale/atrial septum size ratio decreases,and had a foramen ovale valve flap diameter /aortic root size ratio increases in fetuses with hypoplastic left heart syndrome.A combination of the above two ratios,supplemented by observation of the fetal foramen ovale hemodynamic characteristics,it will be helpful for the diagnosis of fetal hypoplastic left heart syndrome.