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| Clinical Application Value of Prenatal Echocardiography in Diagnosis of Fetal Pulmonary Artery Stenosis and Postpartum Follow-up Analysis |
| Ma Minya, Liu Liu, Kang Mao, Jing Qiao |
| Department of Ultrasound Medicine,Zhumadian Central Hospital,Zhumadian 463000,China |
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Abstract Objective To explore the diagnostic points and change rules ofprenatal echocardiography（UCG）for fetal pulmonary artery stenosis,and analyze short-term UCG follow-up results after surgery. Methods Ultrasound findings of 57 fetuses with pulmonary artery stenosis diagnosed by prenatal UCG were analyzed retrospectively.UCG image characteristics of fetal pulmonary artery stenosis were summarized.Infants were followed up after birth,andUCG image characteristics at 1 month and 3 months after birth were analyzed. Results There were 51 neonates with different degrees of pulmonary artery stenosisconfirmed by UCG,including 39 cases of pulmonary valve stenosis and 12 cases of main pulmonary artery stenosis.6 cases were misdiagnosed by prenatal UCG.UCG of prenatal pulmonary valve stenosis was characterized by right cardiac enlargement,pulmonary valve thickening,mild to moderate pulmonary valveregurgitation,decreasedof the ratio of the inner diameter of theaortato the pulmonary artery,and turbulent blood flow signals seen by ultrasound.UCG of prenatal main pulmonary artery stenosis was characterized by pulmonary artery diameter smaller than the aorta diameter,with different degrees of intracardiac malformations.The pulmonary artery flow velocity,tricuspid regurgitation velocity and right atrial diameter of fetuses in severe stenosis group were larger than those in mild stenosis group and moderate stenosis group（P<0.05）.Thepulmonary artery to aortic diameter ratio and right ventricular diameter were smaller thanmild stenosis group and moderate stenosis group（P<0.05）.1 month after birth,ultrasound of infants with pulmonary valve stenosis showed pulmonary valvethickening,echo enhancementand valve expansion.Ultrasound of infants with pulmonary artery stenosis showedpulmonary artery wall thickening.3 months after birth,the right atrial/ventricular diameter,tricuspid regurgitation velocity and pulmonary artery pressure of the infants recovered,compared with those at 1 month after birth（P<0.05）. Conclusion Prenatal UCG has high clinical application value in diagnosis of fetal pulmonary artery stenosis.UCG follow-up of fetuses before and after birth is beneficial tocondition and prognosis evaluation.
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Received: 15 May 2022
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2023, Vol. 43 
