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Fetal Echocardiography in Diagnosing Congenital Heart Disease Prenatally

دور صدى القلب الجنيني في تشخيص العيوب القلبية الولادية في أثناء الحياة الرحمية

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 Publication date 2012
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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Prenatal detection of congenital heart disease is possible from the 16th week of pregnancy. the ideal time being the Midtrimester ,when the most cardiac abnormalities can be detected ,where all routine cross sectional views are easily obtainable. To evaluate the detection and accuracy of fetal echocardiography for congenital heart defects among high risk pregnancies.


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Research summary
تتناول هذه الدراسة دور تخطيط صدى القلب الجنيني في تشخيص العيوب القلبية الولادية أثناء الحياة الرحمية. تم إجراء تصوير وتخطيط صدى القلب الجنيني بشكل استباقي عند 300 حامل في مستشفى الأطفال الجامعي بين مارس 2007 ومارس 2011، حيث تراوح العمر الحملي بين 20-38 أسبوعًا. أظهرت النتائج أن وجود قصة عائلية إيجابية لعيب قلبي ولادي شكل نحو نصف الحالات، بينما شكلت الحالات المحولة من الطبيب المولد نحو 36%. تم تشخيص العيوب القلبية الولادية في 15 حالة بنسبة 5%، وتم تأكيد التشخيص بعد الولادة. تم إنهاء الحمل في 5 حالات، وحدث موت عفوي للجنين في حالة واحدة، وحدثت الوفاة في حالتين بعد الولادة. تشير الدراسة إلى أن تخطيط صدى القلب الجنيني يمكن أن يكشف معظم العيوب القلبية الولادية واضطرابات النظم الجنينية، مما يوفر الفرصة لوضع استراتيجية مثالية للتدبير أثناء الحمل وبعد الولادة، خاصة في الحمول عالية الخطورة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة في مجال تشخيص العيوب القلبية الولادية أثناء الحياة الرحمية، حيث تقدم بيانات قيمة حول فعالية ودقة تخطيط صدى القلب الجنيني. ومع ذلك، يمكن توجيه بعض النقد البناء للدراسة. أولاً، العينة المستخدمة في الدراسة قد تكون محدودة من حيث الحجم والتنوع الجغرافي، مما قد يؤثر على تعميم النتائج. ثانياً، لم تتناول الدراسة بشكل كافٍ العوامل النفسية والاجتماعية التي قد تؤثر على قرار إنهاء الحمل أو استمراره بعد اكتشاف العيوب القلبية. وأخيراً، كان من الممكن أن تكون الدراسة أكثر شمولية إذا تضمنت متابعة طويلة الأمد للأطفال الذين تم تشخيصهم بعيوب قلبية ولادية بعد الولادة، لتقييم تأثير التدخلات الطبية على جودة حياتهم.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو تقييم دور تخطيط صدى القلب الجنيني ودقته في كشف العيوب القلبية الولادية أثناء الحياة الرحمية.

  2. ما هي نسبة الحالات التي تم فيها تشخيص العيوب القلبية الولادية؟

    تم تشخيص العيوب القلبية الولادية في 15 حالة بنسبة 5% من إجمالي الحالات المدروسة.

  3. ما هي العوامل الأكثر شيوعاً التي أدت إلى إجراء تخطيط صدى القلب الجنيني؟

    العوامل الأكثر شيوعاً كانت وجود قصة عائلية إيجابية لعيب قلبي ولادي بنسبة 49%، والحالات المحولة من الطبيب المولد بنسبة 36%.

  4. ما هي التوصيات النهائية للدراسة؟

    توصي الدراسة بأن تخطيط صدى القلب الجنيني يمكن أن يكشف معظم العيوب القلبية الولادية واضطرابات النظم الجنينية، مما يوفر الفرصة لوضع استراتيجية مثالية للتدبير أثناء الحمل وبعد الولادة، خاصة في الحمول عالية الخطورة.


References used
Lisa K. Hornberger‚ Stephen P.Sanders‚ Azaria J.J.T.Rein. Left Heart Obstructive Lesions The Midtrimester Fetus A Longitudinal Study. Circulation.1995;92:1531-1538
Lindsey D Allan. Echocardiographic Detection Of Congenital Heart Disease In The Fetus: Present And Future. Br Heart J. 1995;74:1030-1036
Juile Tan ‚ Norman H.Silverman‚ Juilen I.E. Hoffman. Cardiac Dimensions Determined By Cross-Sectional Echocardiography In The Normal Human Fetus from 18 Weeks To Term. Am J Cardiol .1992;70:1459-1467
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