| ObjectivesCongenital heart disease (CHD) of which the incidence is8-10‰, is one of themain causes of death of live births.Its also one of the most common fetal congenitalmalformations.Every year there are1.2to2.0million new live births CHD.Some ofthem with complex malformation and poor treatment effect,may pass away earlybirth,which bring families and society a heavy burden.Which Fetal CHD progressesin uterus,its also associated with hemodynamic changes.Ductus venous(DV)is one ofthe major blood vessels to maintain the fetal circulation.Blood flow characteristics ofDV has a close relation with fetal heart structure and function, and its sensiton tosome fetal hemodynamic change.This study aimed to analyeze the hemodynamiccharacterisrics of fetuses with congenital right heart obstructive malformations,inorder to explore the relationship between CHD and DV blood flow characteristics.MethodsThe source patients were pregnant women in our hospital form August2010toNovember2013.During the study period282cases of patients had collected,253hadcomplete hemodynamic data, including184cases of normal fetuses,69case of rightheart obstructive malformation.Patients with righr heart obstructive malformationswere divided in two groups by whether there was shunting between left ventricularand right ventricular.In Group A(pressure balanced left ventricular and right ventri-cular)34cases include:double outlet right ventricle with pulmonary stenosis (n=7),tetralogy of Fallot (n=24), pulmonary atresia with ventricular septal defect (n=3).InGroup B(increased right ventricular pressure)35cases include: tricuspid atresia(N=2),Ebstein’s malformation (N=7),pulmonary stenosis (N=18), pulmonary atresiawith intact ventricular septum (N=8).Normal fetal DV parameters in each spectrumwere depicted (blood flow velocity parameters: ventricular systolic velocity (S),ventricular diastolic velocity (D), atrial systolic velocity (A); resistance parameters: resistance index (RI) and venous peak flow relations Index (PVIV)) relationshipbetween gestational age, and compared among normal group and different types ofright heart obstructive malformations groups.By SPSS17.0software,P <0.05wasconsidered statistically significant.ResultsIn89.7%of the cases fetal DV blood flow was detected clearly by ultrasoundexamination.In normal fetal group fetal DV blood flow parameters(S,D,A)andgestational weeks were positive correlation.The correlation coefficients were0.22,0.16,0.20(P<0.05).Resistance parameter (RI, PVIV) was negatively correlated, thecorrelation coefficients were-0.16,-0.14(P<0.05);The group B DV blood flow A wavecompared with that of normal group was significant different (P<0.05).And theresistance parameter(RI,PVIV) increased significantly(P <0.05);In group A,DV bloodflow velocity parameters and resistance parameters no significant difference from thenormal group,and the velocity parameters A wave wasn’t reversed.However in groupB15cases showed reversed DV flow velocity parameter A wave which wasstatistically significantly different from normal fetuses and group A (P<0.001).ConclusionsBy the technique of two-dimensional doppler most of the fetus DV bloodspectrum can be afetected and measrred and most the of parameters are related togestational weeks.Changes in fetus DV blood flow parameters are also related todifferent types of right heart obstructive malformations In fetal CHD associated withelecated right ventricle pressure, DV flow velocity A wave inversion and DVresistance parameters elevated.Its be used to prompt the right heart obstructivemalformations CHD and initially. observed.Especially in the case where the structureis not a good display of the heart. |
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