Clinical significance of ultrasonic diagnosis in fetal cardiac tricuspid regurgitation of middle-late pregnancy / 中国医师进修杂志

ABSTRACT

Objective:To investigate the clinical significance of ultrasonic diagnosis in fetal cardiac tricuspid regurgitation of middle-late pregnancy.Methods:The clinical data of 80 middle-late pregnancy with ultrasound images of fetal cardiac tricuspid regurgitation in Cixi People′s Hospital of Zhejiang Province from June 2017 to June 2019 were retrospectively analyzed. The velocity of tricuspid regurgitation, ratio of color bundle of tricuspid regurgitation to right atrium, ratio of right atrial diameter to left atrial diameter and venous catheter atrial contraction wave A were detected by color Doppler ultrasound, and the prognosis of fetal was recorded. Among them, 49 cases with physiological reflux was as control group, and 31 cases with pathological reflux (congenital structural abnormality of the heart and no-congenital structural abnormality of the heart which affected the heart function) was as abnormal group.Results:The velocity of tricuspid regurgitation, ratio of color bundle of tricuspid regurgitation to right atrium, ratio of right atrial diameter to left atrial diameter in abnormal group were significantly higher than those in control group (243.39 ± 100.31) cm/s vs. (120.23 ± 40.12) cm/s, (45.9 ± 12.3)% vs. (15.4±2.3)% and 1.30 ± 0.32 vs. 1.08 ± 0.04, the venous catheter atrial contraction wave A was significantly lower than that in control group (7.96 ± 3.21) cm/s vs. (35.01 ± 4.58) cm/s, and there were statistical differences ( P<0.05). One month after birth, the 49 children in control group were reexamined with cardiac ultrasound, among whom cardiac tricuspid regurgitation disappeared was in 15 cases, and cardiac tricuspid regurgitation decreased in different degrees was in 34 cases. In the 31 cases of abnormal group, congenital structural abnormality of heart was in 23 cases, and no-congenital structural abnormality of heart was in 8 cases; there were neonatal death in 4 cases, fetal death in 2 cases, and induced labor in 8 cases; the other 17 cases had better postnatal condition, and the cardiac ultrasound 1 month after birth showed that cardiac tricuspid regurgitation decreased or disappeared. Conclusions:Prenatal detection of the fetal tricuspid regurgitation has a great significance, and fetal prognosis can be assessed according to the etiology and the degree of the reflux.