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胎儿期心律失常的诊断及其临床意义探讨

         

摘要

Objective To evaluate the diagnosis and clinical significance of fetal arrhythmias. Methods Fifty seven cas-es of fetal arrhythmias were detected from July 2010 to Jan 2012 in Woman's Hospital, Zhejiang University School of Medicine and Fenghua Maternal and Child Hospital. The maternal medical history, fetal electrocardiograph,echocardiograph and pregnant results were analyzed. Results In 57 cases of fetal arrhythmias, 7.0%were diagnosed as fetal tachycardia, 3.5%as fetal brady-cardia and 89.5%as irregular fetal cardiac rhythm. Without special treatment, heart rate and rhythm returned to normal during the pregnancy in 21 cases (36.8%). The heart rate and rhythm returned to normal after birth in 15 cases (26.3%), and within 7 days postnatal y in 14 (24.6%). Four cases(7.0%) were diagnosed as congenital heart disease. Conclusion Most fetal arrhythmias can recover to normal during pregnant period or postnatal y. Persistent arrhythmias and hydrops fetalis are associated with negative prognosis.%目的:探讨胎儿期心律失常的诊断方法、临床意义及对新生儿预后的影响。方法收集产前检查中发现胎儿心律失常的57例孕妇资料,分析孕妇病史、胎儿心电图、胎儿超声心动图、妊娠结局等。结果胎儿心律失常中胎儿心动过速、胎儿心动过缓和不规则胎儿心律的发生率分别为7.0%、3.5%和89.5%。经期待疗法,孕期胎儿心律恢复正常的有21例(36.8%),出生后新生儿心律迅速恢复正常的有15例(26.3%),产后7d新生儿心律恢复正常的有14例(24.6%)。4例胎儿(7.0%)发现心脏结构异常。结论大部分胎儿心律失常与胎儿的心脏调节功能尚未完善有关,约91.2%在分娩前或出生后心律恢复正常;胎儿期心律失常预后不良相关的因素为胎儿水肿、持续性心律失常。

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