在产前超声检查中发生大动脉缩的危险因素:系统性审查和元分析

Alessandra Familiari ¹, Maddalena Morlando ¹, Asma Khalil ¹

¹From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George's Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology, IRCCS San Martino Hospital University of Genoa, Italy (C.S.); Department of Obstetrics and Gynaecology, University of TorVergata, Rome, Italy (G.R.); Department of Medicine and Aging Sciences, University of Chieti-Pescara, Italy (M.E.F.); Department of Medical Sciences, University of Ferrara, Italy (L.M.); Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (G.A.); and Department of Clinical Medicine, UiT- The Arctic University of Norway and Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø (F.D.A.).
²From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George's Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology, IRCCS San Martino Hospital University of Genoa, Italy (C.S.); Department of Obstetrics and Gynaecology, University of TorVergata, Rome, Italy (G.R.); Department of Medicine and Aging Sciences, University of Chieti-Pescara, Italy (M.E.F.); Department of Medical Sciences, University of Ferrara, Italy (L.M.); Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (G.A.); and Department of Clinical Medicine, UiT- The Arctic University of Norway and Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø (F.D.A.). francesco.dantonio@uit.no.

⁰From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George's Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology, IRCCS San Martino Hospital University of Genoa, Italy (C.S.); Department of Obstetrics and Gynaecology, University of TorVergata, Rome, Italy (G.R.); Department of Medicine and Aging Sciences, University of Chieti-Pescara, Italy (M.E.F.); Department of Medical Sciences, University of Ferrara, Italy (L.M.); Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden (G.A.); and Department of Clinical Medicine, UiT- The Arctic University of Norway and Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø (F.D.A.).

通过使用多参数预测模型,可以改善对主动脉缩 (CoA) 的产前诊断. 这种方法提高了发现这一具有挑战性的先天性心脏缺陷的几率.

科学领域

心脏病学
产前诊断
医学成像

背景情况

在产前诊断大动脉缩 (CoA) 仍然具有挑战性,错误阳性结果的比例很高.
准确的产前鉴定对及时干预和改善结果至关重要.

研究的目的

评估各种超声波标记器的诊断准确性,以预测产前动脉缩.
确定特定超声波发现与CoA存在之间的关联强度.

主要方法

在Medline,Embase,CINAHL和Cochrane数据库中进行了全面的文献搜索.
使用随机效应和等级总结接收器操作特征模型的元分析被用于分析12项研究 (922个胎儿) 的数据.

主要成果

在患有冠状动脉的胎儿中,观察到较低的中枢直径z-score和较高的三角直径z-score.
肺动脉直径与上升动脉直径的比率增加是CoA的重要指标.
大动脉的低成形和缩架与CoA有很强的关联,而持续的左上静脉和心室隔膜缺陷并不是显著的预测因素.

结论

采用综合多种超声波信号的多重标准预测模型可以提高大动脉缩的检测率.
需要使用标准化成像方案进行进一步的大规模多中心研究,以开发产前冠状炎的客观风险评估模型.

关键词:

甲状腺硬化胎儿心声检查心脏缺陷,先天性在产前诊断

在产前超声检查中发生大动脉缩的危险因素:系统性审查和元分析

概括

科学领域

背景情况

研究的目的

主要方法

主要成果

结论

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在产前超声检查中发生大动脉缩的危险因素:系统性审查和元分析

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概括

科学领域

背景情况

研究的目的

主要方法

主要成果

结论

关键词:

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