PRENATAL DIAGNOSIS OF CONGESTIVE HEART FAILURE IN A FETUS WITH A SACROCOCCYGEAL TERATOMA
PRENATAL DIAGNOSIS OF CONGESTIVE HEART FAILURE IN A FETUS WITH A SACROCOCCYGEAL TERATOMA
复制标题
骶尾部畸胎瘤胎儿充血性心力衰竭的产前诊断
作者：
Dale N. Alter;K. Reed;G. Marx;C. Anderson;L. Shenker
二维多普勒超声心动图被用来诊断患有大型骶尾部畸胎瘤的胎儿的充血性心力衰竭。超声检查显示胎儿27.5周，骶骨区有水肿和一个大的实性和囊性肿块。胎儿超声心动图显示心室扩张和心包积液;多普勒超声显示速度和容积流量增加，沿着三尖瓣和二尖瓣返流。分娩时，肿块出血活跃，羊水明显带血，新生儿红细胞压积为10%。我们推测畸胎瘤的子宫内出血导致贫血和高输出量心力衰竭，经多普勒超声心动图证实，并建议所有患有骶尾部畸胎瘤的胎儿通过二维多普勒超声心动图进行评估，以检测是否存在充血性心力衰竭，以便进行适时的治疗干预。
Two-dimensional Doppler echocardiography was used to diagnose congestive heart failure in a fetus with a large sacrococcygeal teratoma. Ultrasound performed for size-date inconsistency revealed a 27.5-week fetus with hydrops and a large solid and cystic mass in the sacral region. Fetal echocardiography showed dilated ventricles and a pericardial effusion; Doppler ultrasound demonstrated increased velocities and volume flows, along with tricuspid and mitral regurgitation. At delivery, the mass was bleeding actively, the amniotic fluid was markedly bloody, and the neonatal hematocrit was 10%. We postulate that intrauterine hemorrhage from the teratoma led to anemia and high-output cardiac failure confirmed by Doppler echocardiography, and suggest that all fetuses with sacrococcygeal teratomas be evaluated by two-dimensional Doppler echocardiography to detect the presence of congestive heart failure, in order to allow well-timed therapeutic interventions.