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Objective To investigate the outcome of fetus with abnormal increase of pulmonary artery systolic pressure at second and third trimester by color Doppler ultrasound . Methods Ninety-five fetuses with a little or mild tricuspid regurgitation ( control group) and 60 fetuses with moderate and severe tricuspid regurgitation (observation group) were included . The degree ,velocity ,and differential pressure of tricuspid regurgitation were measured and the variations of baseline information and the measured value of pulmonary systolic pressure between the two groups were compared . As for the follow -up on observation group ,the pressure of fetus with high pulmonary systolic pressure ( > 20 mmHg) was repeatedly measured every 4 weeks until it return to normal . Results There were significant differences in terms of gestational weeks ,velocity and pressure of tricuspid regurgitation ,as well as pulmonary systolic pressure between the two groups ( P < 0 .001) . Pulmonary systolic pressure was positively correlated with gestational weeks , velocity and pressure of tricuspid regurgitation ( r = 0 .442 ,0 .998 ,0 .999 ;all P < 0 .001 ) ,but had no correlations with the age of pregnant women ( r = - 0 .001 , P = 0 .674) . The follow-up revealed that ,in observation group , 47 cases ( 78 .3％ , systolic pressure < 50 mmHg ) presented with the decreased pulmonary systolic pressure ,the disappeared or the slight appeared regurgitation before birth ,meanwhile , 13 ( 21 .7％ ,systolic pressure ≥ 50 mmHg) exhibited severe tricuspid regurgitation and persistent pulmonary elevation ,with the highest of more than 70 mmHg accompanying the varying degrees of right heart failure . Only one of 13 fetuses died due to persistent pulmonary hypertension and hypoxia ( oxygen saturation <45％ ) . The fetal pulmonary artery systolic pressure of the remaining 12 cases recovered from 5 to 105 days after birth ,with normal heart function . Conclusions The majority of fetal pulmonary arterial hypertension complicated with obvious tricuspid regurgitation is reversible functional alteration , which can restore normality in most cases before or after birth .
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Objective To explore the follow‐up value of ultrasound in fetal tricuspid regurgitation . Methods 44 fetuses who presented with moderate tricuspid regurgitation with differential pressure over 20 mmHg ,dilation of right atria and ventricles were chosen as the observation group .Examinations ,in terms of the degree ,velocity and differential pressure of reflux ,size of heart chamber and the presence pericardial or pleural effusion were carried out once every four weeks from 24 weeks of pregnancy to 9 weeks after birth . Results 40 9.% (18/44) of cases had been getting better before birth .The degree of regurgitation of 56 8.%(25/44) cases significantly decreased or even disappeared from 1 to 62 days after birth .Especially ,3 cases whose regurgitation velocity reached to 4 2. m/s with the differential pressure over 70 mmHg as well as onset of heart failure symptoms had been recovered gradually after born in advance 1. case (2 3.% ) with the persistence of both tricuspid regurgitation and heart failure symptoms after birth died in right heart failure , even though using different active treatments ,such as oxygen ,strong heart and diuresis .Conclusions High‐speed tricuspid regurgitation in fetuses without pathological changes can be almost reversed ,and the prognosis is good .Once the fetal tricuspid regurgitation pressure is over 70 mmHg or a fetus appears the onset of heart failure symptoms ,pre‐term delivery should be advised in a bid to prevent accidents in uterine cavity .
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Objective To investigate a new method for detecting fetal cardiac arrhythmia.Methods Used two kinds of superposition:①left ventricular outflow tract color flow image with right atrium wall motion curves superposition,②left ventricular outflow tract color flow image with left ventricular inflow tract colour flow image superposition,167 cases of fetal arrhythmia were detected.Results Among them,84 fetuses with atrial premature heat,39 with ventricular premature beat,23 with temporal sinus bradycardia,12 with sinus tachycardia,4 with Ⅱ°atrioventricular block(AVB),2 with Ⅲ°AVB,3 with atrial fibrillation.Conclusions Using superposition of M-mode echocardiagraphy with color Doppler imaging to diagnose fetal cardiac arrhythmia is easier and more accurate.
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Objective To explore the corresponding relationship between isolated Q waves in lead Ⅲ on the electrocardiography(ECG) and echocardiographie segmental diagnosis of myocardial infarction(MI).Methods The shape magnitude of Q waves of 27 patients with MI and the relationship with eehocardiographie features were investigated. Results Twenty-four patients with inferior wall myocardial infarction had close relationship with isolated Q waves in lead Ⅲ on the ECG. Conclusions There is definite corresponding relation between isolated Q waves in lead Ⅲ and inferior wall myocardial infarction.
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Objective To study the value of echocardiography in diagnosis of prenatal closure of fetal ductus arteriosus(FDA) and discuss its characteristics. Methods Two cases with prenatal closure and one case with constriction of the FDA were examined.The echocardiographic characteristics were analyzed and the literature was reviewed. Results Right atrial and ventricular dilatation and severe tricuspid valve insufficiency were observed. After timely delivery, impaired right ventricular function improved significantly. Conclusions Fetal echocardiography plays an important role in diagnosis of prenatal closure of the FDA.