ZNAČAJ INTRAKARDIJALNIH EHOGENIH ŽARIŠTA FETALNOG SRCA: SADAŠNJE SHVAĆANJE I KLINIČKA VRIJEDNOST

Objective. To estimate the degree of risk of the echogenic intracardiac foci (IEF) for fetal chromosomopathies and to determine its association with structural anomalies of the fetus. Material and methods. During the period of two years 190 pregnant patients had been send for fetal echocardiography. Examination had been performed by transvaginal¬ (12–17 weeks of gestation) or transabdominal approach (18 weeks or more of gestation). Results. IEF was observed in 17 fetuses, multifocal appearance was found in 2 out of 17 fetuses. In 3 cases IEF had resolved during the 8 weeks period of time. Additional structural anomalies were detected in 11 fetuses. In 2 fetuses trisomy 21 had been confirmed. Conclusion. A single soft marker as IEF is commonly encountered during the second trimester among the fetuses with chromosomal aberation. As do many sonographic markers IEF can be resolved during the pregnancy and often can be found in normal fetuses.Cilj rada je bio na vlastitom uzorku utvrditi u kojoj mjeri ultrazvučni nalaz hiperehogenih intrakardijalnih žarišta (IEF) pridonosi dijagnostici kromosomopatija i strukturalnih anomalija. Uzorak i metode. Tijekom dvije godine 190 trudnica između 12. i 39. tjedna trudnoće je primljeno radi fetalne ehokardiografije. Pregled je obavljen vaginalnom sondom od 5 MHz pri trudnoćama 12.–17. tjedna ili zavinutom abdominalnom sondom od 3,5 MHz nakon 17. tjedna trudnoće. Rezultati. IEF su nađeni u 17 fetusa, multifokalni u 2 od njih. U 3 fetusa su IEF u roku od osam tjedana nestali. U 11 fetusa su nađene dodatne strukturalne anomalije. Trisomija 21 je potvrđena u 2 fetusa. Zaključak. IEF su »meki« ultrazvučni biljezi fetalne aneuploidije, često su prolazni, a nalaze se i u eukariotičnih fetusa

Fetal echocardiography

Napretkom tehnologije i umijećem pretraživača fetalna ehokardiografija postala je sastavni dio suvremene perinatologije. Ona nam omogućuje procjenu struktura i funkciju fetalnog kardiovaskularnog sustava, a time i prognozu ploda, ishod trudnoće, kao i ocjenu moguće postnatalne intervencije. Dvodimenzionalnom ultrazvučnom slikom, bilo transvaginalnim ili transabdominalnim putem, ocjenjujemo kvalitativne anatomske odnose, primjenom dopplera u boji i pulsirajućeg dopplera pristupamo ocjeni funkcionalnog stanja kardiovaskularnog sustava, dok uvođenje 3D, 4D i STIC tehnologije omogućuje još jasniju evaluaciju fetalnog srca u svim presjecima. Strukturne anomalije srca i velikih krvnih žila relativno su često zastupljene u populaciji, u 8 do 9 na 1.000 živorođene djece, dok gotovo pola zahvaćenih fetusa ima pridružene ekstrakardijalne ili kromosomske anomalije. Upravo otkrivanje fetusa s mogućom srčanom greškom i njegova daljnja evaluacija pridonosi značaju primjene fetalne ehokardiografije.Advanced technology as well as an increased capability of the ultrasonographers have expanded the use of the ultrasound as a diagnostic tool for the evaluation of the fetal heart. The ultrasound has enabled us to examine in detail embryonic and fetal development. With existing technology, it is possible to detect fetal abnormalities including heart anomalies at the end of the first trimester of pregnancy. The introducing 3D, 4D and STIC techology gave us more opportunity in the examination of the fetal heart. During the last two decades the fetal echocardiography has been established as a reliable, non – invasive technique for the evaluation of the detailed anatomy of the fetal heart. With the combination of the skilled staff and modern technology, it ispossible to detected most of the structural anomalies, and, through the use of socalled “soft” or “minor” markers, achieve great success in identifying pregnancies at increased risk for aneuploidy

Fetalna ehokardiografija

Advanced technology as well as an increased capability of the ultrasonographers have expanded the use of the ultrasound as a diagnostic tool for the evaluation of the fetal heart. The ultrasound has enabled us to examine in detail embryonic and fetal development. With existing technology, it is possible to detect fetal abnormalities including heart anomalies at the end of the first trimester of pregnancy. The introducing 3D, 4D and STIC techology gave us more opportunity in the examination of the fetal heart. During the last two decades the fetal echocardiography has been established as a reliable, non – invasive technique for the evaluation of the detailed anatomy of the fetal heart. With the combination of the skilled staff and modern technology, it ispossible to detected most of the structural anomalies, and, through the use of socalled “soft” or “minor” markers, achieve great success in identifying pregnancies at increased risk for aneuploidy.Napretkom tehnologije i umijećem pretraživača fetalna ehokardiografija postala je sastavni dio suvremene perinatologije. Ona nam omogućuje procjenu struktura i funkciju fetalnog kardiovaskularnog sustava, a time i prognozu ploda, ishod trudnoće, kao i ocjenu moguće postnatalne intervencije. Dvodimenzionalnom ultrazvučnom slikom, bilo transvaginalnim ili transabdominalnim putem, ocjenjujemo kvalitativne anatomske odnose, primjenom dopplera u boji i pulsirajućeg dopplera pristupamo ocjeni funkcionalnog stanja kardiovaskularnog sustava, dok uvođenje 3D, 4D i STIC tehnologije omogućuje još jasniju evaluaciju fetalnog srca u svim presjecima. Strukturne anomalije srca i velikih krvnih žila relativno su često zastupljene u populaciji, u 8 do 9 na 1.000 živorođene djece, dok gotovo pola zahvaćenih fetusa ima pridružene ekstrakardijalne ili kromosomske anomalije. Upravo otkrivanje fetusa s mogućom srčanom greškom i njegova daljnja evaluacija pridonosi značaju primjene fetalne ehokardiografije