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第 三 半期 の スクリーニング は,先天 的 な 心臓 疾患 の 自然 な 経歴 を 変化 さ せる か 2つの異なる時間帯での地域心臓スクリーニングの結果の分析

Hana Jicinska1, Pavel Vlasin2, Michal Jicinsky2

  • 1From Department of Pediatric Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic (H.J.); Fetal Medicine Center, Brno, Czech Republic (H.J., P.V., I.G.); Children's Heart Center, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic (M.J., V.T., J.S., J.M.); University Hospital Sv. Anny, Brno, Czech Republic (I.G.); Louisiana State University Health-New Orleans, School of Public Health (J.V.); and Great Ormond Street Hospital for Children and Institute of Cardiovascular Sciences UCL, London, UK (J.M.). hjicinska@seznam.cz.

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まとめ

最初の3ヶ月間のスクリーニングは,先天性心不全 (CHD) の診断と妊娠の結果に大きな影響を及ぼします. 重度の心臓病および併発症の早期発見は,妊娠中絶率の増加につながった.

キーワード:
心臓の先天性欠陥エコーカルディオグラフィー流行病学について最初の3ヶ月間のスクリーニング産前心臓科

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科学分野:

  • 産経内科
  • 胎児心臓科
  • 医療診断

背景:

  • 胎児の発達において,先天性心不全 (CHD) は重大な問題である.
  • 最初の3ヶ月間のスクリーニングは,妊娠初期に潜在的な胎児異常を特定することを目的としています.

研究 の 目的:

  • CHDのスペクトルに対する最初の3ヶ月間のスクリーニングの影響を分析する.
  • 心臓病と診断された胎児の妊娠結果への影響を評価する.

主な方法:

  • 2007年から2013年の間に診断された胎児の心臓病の遡及分析
  • 第1 trimester (グループI) と第2 trimester (グループII) で診断されたCHDの比較
  • 第3グループ) と第1グループ) のスクリーニング実施前の第2 trimesterのCHDの比較

主要な成果:

  • 第1期診断 (第1グループ) は,第2グループと比較して,併発症,単胞性アウトカム,子宮内死亡,終末を含む,著しく異なるCHDスペクトルを示した.
  • グループIII (事前スクリーニング) は,グループIIよりも有意に多くの無子宮結末,子宮内死亡,早産を示した.
  • 妊娠第2 trimesterで特定されたCHDのスペクトルは,妊娠第1 trimesterのスクリーニングの導入後に変化しました.

結論:

  • 最初の3ヶ月間のスクリーニングは,CHDのスペクトルと妊娠の結果を大幅に変化させます.
  • 妊娠初期スクリーニングによる重度の慢性疾患および併発症の早期発見は,妊娠中絶率を高めます.