独立行政法人国立循環器病研究センター周産期・婦人科部Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center ◇ 〒565-8565 大阪府吹田市藤白台5-7-15-7-1 Fujishirodai, Suita-shi, Osaka 565-8565, Japan
胎児診断には超音波検査が大きな役割を果たすが，検査の目的は行う時期によって異なる．胎児心臓超音波検査は形態の評価として“スクリーニング”と“診断”との2段階に分けて行われる．胎児超音波検査は単に病名を診断することにとどまらず，胎内での血行動態の評価から分娩後の血行動態の予測，心機能の評価，さらに心外病変の有無など多岐にわたる．その所見で胎内での状態を評価し，出生後の状態を予測する．いくつかの報告では，このような出生前の診断は必ずしも予後の向上につながっていない．今後さらに精度の高い“スクリーニング”と“診断”を実現し，予後の向上を図る必要がある．胎児治療においては，適応のみならず，治療開始および終了の決定なども厳格に行われなくてはならない．
Fetal echocardiography as a screening tool as well as a diagnostic modality has been proven to be safe and accurate for the diagnosis of fetal heart disease. The structure and function of the heart can be assessed by echocardiography. Prenatal echocardiography has the potential for improving postnatal survival in infants with congenital heart defects. However, it remains unclear whether it also improves postoperative outcomes. Prenatal diagnosis possibly identifies patients with more severe phenotypes, resulting in a poor prognosis in this group. Fetal therapy, the treatment of the fetus, is now practical. The current fetal therapeutic strategies range from maternal transplacental medication to the fetus to invasive open-uterine fetal surgery. In fetal therapy, fetal critical disorders must be weighed against the risks to the mother and potential for a successful treatment after birth.
Key words: congenital heart disease; fetal echocardiography; fetal therapy
© 2015 特定非営利活動法人日本小児循環器学会© 2015 Japanese Society of Pediatric Cardiology and Cardiac Surgery
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This page was last modified on 2015-03-23T20:39:21.725+09:00
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