With the development of echocardiography and technology, especially the development of high-resolution anatomical images and modern Doppler technology, it has become possible to use this technology to examine the heart of fetuses above 16 weeks of gestational age. The correct diagnosis of congenital heart disease in the fetal period is extremely important to improve and promote the level of eugenics in our country, and to intervene in congenital heart disease with timely and reasonable treatment.
The causes of malformations in fetal heart development are multiple, and high alert to the occurrence of fetal congenital heart disease is needed if the following high-risk factors exist, mainly including
I. Maternal factors.
1. various types of infectious diseases in the mother’s early pregnancy, especially viral infections, such as rubella, chickenpox, influenza, mumps, etc.
2. various types of diabetes mellitus, especially in insulin-dependent patients in early pregnancy
3, connective tissue diseases, such as systemic lupus erythematosus, rheumatoid arthritis
4, receiving certain drugs or toxic influences during pregnancy: commonly amphetamines, the chemical substance lithium, trimethoprim, dalenidine, alcohol, smoking.
5, advanced maternal age and history of abnormal pregnancy: pregnant women older than 35 years old have an increased chance of chromosomal aberrations in their fetuses.
6, inbreeding: inbreeding is a high risk factor for fetal malformation and precocious heart disease.
Second, from the fetal side of the factors.
1.Suspicious abnormalities of fetal heart found in routine prenatal ultrasonography.
2. Malformations of the following organs are found during routine examination, suggesting a greater association with congenital heart disease.
(1) hydrocephalus.
(2) esophageal atresia, duodenal atresia, jejunal atresia.
(3) umbilical bulge, gastrointestinal bulge
(4) renal hypoplasia; (5) diaphragmatic hernia.
(5) diaphragmatic hernia.
3.Chromosomal abnormalities
Among the fetuses with chromosomal abnormalities, the incidence of congenital heart disease is 50% with the highest incidence of chromosome 21 trisomy, and other chromosome 18 trisomy, Tuner’s syndrome, etc.
4.Fetal cardiac arrhythmias
Fetal arrhythmias include bradycardia, tachycardia and arrhythmia. All the above three conditions are indications for fetal echocardiography.
5.Fetal edema
Fetal edema not caused by immune problems such as hemolysis may be caused by cardiac malformations or cardiac insufficiency.
Family history of congenital heart disease.
There is a genetic component present in this disease. Genetic studies have concluded that most congenital heart diseases are the result of the interaction of multiple genes and environmental factors.
In the last decade or so, with the development of perinatal medicine and the need for cooperation between obstetrics and gynecology, neonatology and pediatric specialties, there is a growing desire to jointly discuss and develop principles of monitoring and treatment during the fetal period, to do timely and comprehensive examination and evaluation of the fetus so as to predict the postnatal condition, and at the same time should promptly talk to the pregnant woman and her family about the condition and prognosis of the fetus and give appropriate interventions.
Prevention of fetal precocious heart disease during pregnancy is mainly to avoid the aforementioned factors related to this disease during pregnancy. Patients with precocious heart disease who survive to adulthood should be arranged to work according to their cardiac function. Patients without cyanosis are generally competent to have children, but parents with precocious heart disease have more chances of their children having precocious heart disease, and patients with right-to-left shunt should not be pregnant.
Preventive measures include.
1. Avoid colds and flu in early pregnancy and go to public places less often. This is an important measure to prevent congenital heart disease.
2. Routine ultrasound examination: when the heart is close to perfect development (above 16 weeks of gestation), perform ultrasound to check the development of the fetal heart. If the fetal heart has heart malformations and is complicated, such as left ventricular dysplasia syndrome, etc., it is necessary to consider surrendering the fetus.
3, avoid radioactive substances and places, but there is no definite evidence yet.
4, avoiding home renovation, whose resulting air pollution has an inexact effect on heart development, which may affect fetal development
5.Parental alcohol consumption and smoking can affect the development of the fetus
6.Avoid taking and contacting teratogenic drugs and poisons.