先天性心疾患の出生前診断が普及するとともに，小児循環器医療はこの20年前で大きく変化してきた．先天性心疾患の胎児診断率やその精度は21世紀に入り明らかに向上し，出生後の予後にも影響を及ぼしている．しかしながら，単独の総肺静脈還流異常症などの診断率は高くなく，これらの診断率を上げていくことが今後の課題となる．また，胎児診断に基づいた出生後の適切な新生児管理や胎児治療も今後の取り組むべき課題であろう．胎児治療のなかでも胎児カテーテル治療は日本ではこれからの分野であり，適応患者を抽出し，安全性を担保しつつ有効性の確認を行っていかなければならない．この総説では，筆者の経験や研究と過去の論文をもとに先天性心疾患の胎児診断と胎児心エコーの基本，そして，胎児カテーテル治療について述べた．皆様の今後の診療に少しでもお役に立てるならば幸いに思う．
Pediatric cardiology has changed greatly in a few decades, along with the spread of prenatal diagnosis of congenital heart disease (CHD). The improvement of prenatal detection rate and its accuracy resulted in optimal outcomes after birth. However, the detection rate has been still low in some CHDs, such as isolated total abnormal pulmonary venous connection. In the future, increasing the detection rate of these CHDs will be a challenge. Proper neonatal management based on fetal diagnosis and fetal intervention is also an issue to be addressed. Fetal catheter intervention is an emerging field in Japan, and it is necessary to identify the appropriate patients and confirm the safety and efficacy of this treatment. This review article describes the basics of fetal diagnosis, echocardiography, and fetal intervention, based on the author’s experience, research, and previous articles. We hope that this article can help you in your practice.
Key words: congenital heart disease; prenatal detection; fetal echocardiography; fetal catheter intervention
© 2021 特定非営利活動法人日本小児循環器学会© 2021 Japanese Society of Pediatric Cardiology and Cardiac Surgery
This page was created on 2022-01-28T09:21:00.004+09:00
This page was last modified on 2022-03-08T10:40:37.000+09:00
このサイトは（株）国際文献社によって運用されています。
