| 刘建新,王贤明,郭少文,张文君*.早孕期胎儿心脏轴线变化及其临床意义[J].中国医学影像技术,2014,30(1):103~106 |
| 早孕期胎儿心脏轴线变化及其临床意义 |
| Changes and clinical value of fetal cardiac axis in the first trimester of pregnancy |
| 投稿时间：2013-08-11 修订日期：2013-11-24 |
| DOI： |
| 中文关键词: 胎儿心脏 妊娠初期 超声心动描记术 |
| 英文关键词:Fetal heart Pregnancy trimester, first Echocardiography |
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| 中文摘要: |
| 目的 观察早孕期胎儿心脏轴线的变化规律及其临床意义。方法 对123胎胎龄9~12+6周正常早孕期胎儿行心脏超声检查，其中18胎接受2次检查，共检查141胎次。另筛选8胎有严重先天性心脏病的胎儿作为对照。上述所有胎儿均经中晚孕期或出生后超声检查进一步确诊。结果 早孕期胎儿心脏轴线：9~9+6周为32.3°±10.7°（第1组），10~10+6周为42.1°±9.6°（第2组），11~11+6周为48.3°±8.7°（第3组），12~12+6周为49.2°±8.6°（第4组）。除第3组与第4组间差异无统计学意义外（P>0.05），余两两组间差异均有统计学意义（P均<0.05）。8胎严重先天性心脏病胎儿中，3胎心脏轴线大于正常胎儿心脏轴线第90百分位数，3胎心脏轴线小于正常胎儿第10百分位数。结论 胎龄<9周胎儿心脏轴线相对居中，≥9周时开始较明显向左旋转，妊娠12周时胎儿心脏轴线较恒定。孕13周前超声发现异常心脏轴线有利于早孕期超声诊断先天性心脏病。 |
| 英文摘要: |
| Objective To observe changes and clinical value of normal fetal cardiac axis in the first trimester of pregnancy. Methods Echocardiograms of 141 fetuses obtained from 9 to 12+6 weeks gestation in 123 healthy pregnancies (performed twice in 18 fetuses) were reviewed. Eight fetuses with severe congenital heart disease were studied in the first trimester of pregnancy. Echocardiography was performed for all fetuses in the second or third trimester or even after birth. Results The mean fetal cardiac axis was 32.3°±10.7° for 9—9+6 weeks (group 1), 42.1°±9.6° for 10—10+6 weeks (group 2), 48.3°±8.7° for 11—11+6 weeks (group 3), 49.2°±8.6° for 12—12° weeks (group 4). No significant difference was found between group 3 and group 4, whereas significant differences were found between other two groups (all P<0.05). The cardiac axis was >90th centile in 3 fetuses and <10th in 3 fetuses with severe congenital heart diseases. Conclusion When gestational age <9 weeks, the cardiac axis is relatively near to midline, and then begin to rotate to the left. At 12 weeks gestation, the fetal axis becomes stable. Abnormal findings of fetal cardiac axis before 13 weeks gestation may contribute to early ultrasonic detection of congenital heart diseases. |
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