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What are the common problems of fetal cardiac ultrasound during pregnancy?
As a non-invasive imaging diagnostic technique, the accuracy of ultrasound examination is difficult to reach 100%. In addition, the accuracy of ultrasound diagnosis is greatly influenced by the experience of the examining physician, especially in cardiac ultrasound and fetal heart ultrasound.
Therefore, if the large-scale ultrasound examination during pregnancy reveals that the fetal heart has a problem or is suspicious, go to a specialist hospital and find an experienced ultrasound doctor who is familiar with congenital heart disease. A comprehensive and accurate fetal echocardiographic report is an important basis for clinicians to predict their condition and develop treatment plans.
The following is a detailed discussion of common problems with fetal heart ultrasound.
1, Forever left superior vena cava
The permanent left superior vena cava refers to the venous blood flow of the left head and neck and the left upper limb, which is directly returned to the right atrium through the superior vena cava on the left side. This is a normal anatomical variation that has no effect on the circulation and does not require disposal. But relatively speaking, the left superior vena cava is more likely to appear with other congenital heart diseases. Therefore, it is best to do a special fetal heart ultrasound examination, carefully observe the heart structure, except for other cardiac malformations.
2, The heart of the indoor light point
In most cases, there is no problem. The strong light point is the echo of the normal structure of the heart such as the leaf chord, papillary muscles, etc. It may be because the child's heart is small, and these tissue structures are difficult to clearly distinguish. In rare cases, the glare point is a ventricular tumor, which requires dynamic observation of tumor size and number changes.
3, The oval hole is too large
It is currently believed that the size of the foramen ovale observed during ultrasound can not completely predict whether there will be atrial septal defect after birth.
To take a step back, according to current medical technology, atrial septal defect is a simple congenital heart disease that can be completely cured by intervention or surgery. The success rate of treatment can reach 99% or higher.
4, The foramen ovale is small, the arterial catheter is twisted
Keeping the foramen ovale and the opening of the arterial catheter during pregnancy and blood flow are necessary to maintain normal fetal circulation. If the foramen ovale is closed, or becomes small and cannot pass through the bloodstream effectively, the fetal blood flow circulation will be abnormal, such as edema, heart rate speeding up or slowing down. Therefore, the child's fetus is in good condition, and it is very likely that the ultrasound measurement is biased. Distortion of the arterial catheter does not affect the flow of blood, which is of little clinical significance.
However, for the sake of caution, attention should be paid to the observation of fetal heart rate and, if necessary, cardiac ultrasound.
5, Right aortic arch
For the simple right aortic arch without other malformations in the heart, most children will have no problems in the future. Only a small number of patients with left arterial catheter or vagus left subclavian artery may have pressure on the trachea and esophagus after birth, and have symptoms such as difficulty swallowing, difficulty breathing, and repeated respiratory infections. Severe symptoms require surgery.
6, Aortic arch narrowing
In general, due to the cardiovascular anatomy and circulation characteristics of the fetus, the fetal heart is rapidly growing and developing, and the ultrasound window is limited by the mother's sonography. It is difficult to accurately diagnose the presence or absence of aortic arch constriction and narrowing during pregnancy. For those suspected of having abnormal aortic arch during pregnancy, the child should be examined by echocardiography as soon as possible after birth, and if necessary, assisted in the diagnosis of cardiac CT to facilitate the development of a treatment plan. Children with severe aortic coarctation or aortic arch interruption require monitoring and treatment at birth, so confirming the diagnosis is critical.
7, tricuspid regurgitation
First, the ultrasound should observe the structure of the tricuspid valve as abnormally as possible. If the tricuspid valve structure is normal, a small amount of reflux has no effect on the heart, and there is no need to dispose of it. The condition allows the ultrasound to be reviewed after several weeks to observe whether the return flow has changed.
If the tricuspid valve is abnormal, or if there is a median or more regurgitation, the ultrasound should be reviewed periodically and the reflux should be observed dynamically.
A large number of tricuspid regurgitation may affect the fetal heart function, and special attention should be paid to regular follow-up. The child is reviewed as soon as possible after birth and the diagnosis is confirmed. Some critically ill children may need supervision and treatment as soon as they are born.