胎児の心疾患  [in Japanese] Heart Disease in the Fetus  [in Japanese]

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Author(s)

    • 前野 泰樹 MAENO Yasuki
    • 久留米大学医学部小児科総合周産期母子医療センター Maternal and Perinatal Medical Center, Department of Pediatrics and Child Health, Kurume University School of Medicine
    • 神戸 太郎 KANBE Taro
    • 久留米大学医学部小児科総合周産期母子医療センター Maternal and Perinatal Medical Center, Department of Pediatrics and Child Health, Kurume University School of Medicine
    • 廣瀬 彰子 HIROSE Akiko
    • 久留米大学医学部小児科総合周産期母子医療センター Maternal and Perinatal Medical Center, Department of Pediatrics and Child Health, Kurume University School of Medicine
    • 姫野 和家子 HIMENO Wakako
    • 久留米大学医学部小児科総合周産期母子医療センター Maternal and Perinatal Medical Center, Department of Pediatrics and Child Health, Kurume University School of Medicine
    • 藤野 浩 FUJINO Hiroshi
    • 久留米大学医学部小児科総合周産期母子医療センター Maternal and Perinatal Medical Center, Department of Pediatrics and Child Health, Kurume University School of Medicine
    • 松石 豊次郎 MATSUISHI Toyojiro
    • 久留米大学医学部小児科総合周産期母子医療センター Maternal and Perinatal Medical Center, Department of Pediatrics and Child Health, Kurume University School of Medicine

Abstract

胎児の心疾患を診断し有効な周産期管理に結びつけるためには, 一次施設でのスクリーニングと, それによる二次施設への紹介による正確な診断と管理方針の決定が必要である. 胎児心疾患のスクリーニング法は簡便であり, 専門的な先天性心疾患の知識は必要ない. (1) 左右の判定と, ごく単純な二つの胎児横断面である, (2) 4-chamber viewと, (3) 3-vessel viewを描出して評価し, 異常のある可能性を指摘できることが重要である. スクリーニングの普及には経験を積んだ検査技師や助産師, 看護師などのコメディカルが胎児エコーを施行することも有効と考えられる. 実際に胎児の心奇形が診断された時には, それを有効な周産期管理に生かすためには小児循環器科医の知識は不可欠であり, さらに胎児心疾患に特有な問題点の知識が必要である. 胎児の不整脈では, Mモード法とドプラ法の双方を利用しながら, 正確な診断の上に適確な胎内治療を含めた周産期管理を行うことが重要である.

Effective fetal diagnosis of heart disease requires accurate screening at the first level hospital, and optimal perinatal management at the referral hospital. The method used to screen cases of the fetal heart disease must be easy and not require specific knowledge of congenital heart disease. This screening entails three steps: determining which side of the chest the heart is located in, checking the four-chamber view, and checking the three-vessel view. Screening performed by the comedical staff, comprising midwives, nurses, and technicians, can prove valuable. Optimal planning for perinatal management is crucial when heart disease is detected. Although the pediatric cardiologist is important in this planning, additional knowledge specific to the fetal cardiac disease is essential. Similarly, detailed diagnosis based on the results of both M-mode and Doppler ultrasound examination is important when fetal arrhythmia is detected. Optimal prenatal treatment and perinatal management can be based on this diagnosis.

Journal

  • Choonpa Igaku

    Choonpa Igaku 33(4), 493-501, 2006-07-15

    The Japan Society of Ultrasonics in Medicine

References:  12

Codes

  • NII Article ID (NAID)
    10020611978
  • NII NACSIS-CAT ID (NCID)
    AN1059477X
  • Text Lang
    JPN
  • Article Type
    REV
  • ISSN
    13461176
  • Data Source
    CJP  J-STAGE 
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