RESUMEN
Objective To explore the characteristics of branch pulmonary artery flow patterns in fetuses with left heart hypoplasia syndrome (HLHS).Methods HLHS fetuses were divided into an unobstructed group and an obstructed group according to the blood flow pattern across the interatrial septum.Main pulmonary artery diameter,right pulmonary artery diameter,and Doppler parameters of first-order right pulmonary artery of both groups were measured by fetal echocardiography and compared with those of normal controls.Results There was a significant difference in the diameter of pulmonary trunk among different the three groups (F=198.56,P ＜ 0.05),and the main pulmonary artery diameter in the two groups of HLHS fetuses were larger than that in normal controls (t=-18.501,-13.97,P ＜ 0.05),but there was no significant difference between the two groups of HLHS fetuses (P=0.85).There was no significant difference in right pulmonary artery diameter among the three groups (P=0.59).The end-diastolic velocity,time-averaged maximum velocity,and velocity-time integral in the two HLHS groups were lower than those in normal controls,and these parameters in the obstructed group were less than those in the unobstructed group.The pulmonary artery pulsatility index in the two HLHS groups was higher than those in normal controls,and it was higher in the obstructed group than in the unobstructed group.There was no statistically significant difference in peak systolic velocity among the three groups (P=0.34).Conclusion The antegrade resistance of the pulmonary arteries of HLHS fetuses increase and these pathologcial conditions are more obvious in those with obstructed flow across the atrial septum compared to those with unobstructed flow.
RESUMEN
Se presenta el caso clínico de una gestante de 30 años de edad con antecedentes de captación tardía a las 20 semanas de gravidez, por lo que no se le realizaron la alfa-fetoproteína y la ecografía del primer trimestre. Posteriormente, se le efectuó la pesquisa ultrasonográfica del segundo trimestre en el Hospital General "Alberto Fernández Montes de Oca" del municipio de San Luis en Santiago de Cuba y se observó un embarazo gemelar bicoriónico biamniótico y la presencia de una anomalía en uno de los fetos: hipoplasia de las cavidades cardíacas izquierdas, cuyo diagnóstico fue confirmado a través de una ecocardiografía fetal en el Cardiocentro de esta provincia.
The case of a 30 year-old pregnant woman with history of first prenatal visit at 20 weeks of pregnancy is reported, reason why alpha fetoprotein test and ultrasound of the first trimester were not made. Subsequently, ultrasound scan of the second trimester was performed at "Alberto Fernández Montes de Oca" General Hospital of San Luis municipality in Santiago de Cuba, and a bichorionic biamniotic twin pregnancy and the presence of an anomaly in one fetus were found: hypoplasia of the left heart, diagnosis of which was confirmed through a fetal ultrasound at the Heart Center of this province.