tailieunhanh - Heart Disease in Pregnancy - part 2

Siêu âm tim thai nhi Trong 20 siêu âm tim qua bào thai năm đã trải qua sự phát triển lớn. Trái tim thường có thể được hình dung tại 16-18 tuần gestation20, 21 và bất thường có thể được phát hiện sớm nhất là 18-20 , 23 xem duy nhất có giá trị | Cardiovascular examination in pregnancy 27 Table Routine checklist of fetal echocardiography Heart one-third of the fetal thorax Two atria of equal size Two ventricles of equal size contracting briskly Two equal size atrioventricular valves Patent foramen ovale Intact ventricular septum presence and extent of ischemia in high-risk patients with possible coronary artery disease. Fetal echocardiography Over the past 20 years fetal echocardiography has undergone major developments. The heart can usually be visualized at 16-18 weeks gestation20 21 and abnormalities can be detected as early as 18-20 23 The single most valuable view is the four-chamber view centered on the atrioventricular junction. It gives the opportunity to assess the number and relative sizes of the ventricles and atria as well as the atrioventricular valves and can be obtained in 95 of The following features should be sought Table The heart should occupy no more than one-third of the fetal thorax There should be two atria of equal size There should be two ventricles of equal size that contract equally briskly The two atrioventricular valves should meet the atrial and ventricular septa at the crux The foramen ovale should be present The ventricular septum must be intact. Fetal echocardiography should be performed by operators with skills based on experience of pathology rather than just on the performance of a large number of normal scans. Transvaginal fetal echocardiography facilitates early visualization of the fetal heart. Recognition of cardiovascular pathology is of great importance to adjust any medication appropriately and to plan the delivery and mode of anesthesia. There are a few cardiac conditions such as Eisenmenger syndrome and primary pulmonary hypertension that indicate the need for early interruption of pregnancy because of high maternal risk. References 1 Turnbull A Tindall VR Beard RW et al. Report on confidential enquiries into maternal deaths in