中文摘要：

目的探讨中晚孕期胎儿静脉导管A波倒置的临床诊断价值。方法选取资料完整的静脉导管A波倒置胎儿27胎，分析胎儿先天性心脏畸形特点，并与尸体检查及新生儿随访结果相对照。结果27胎静脉导管A波倒置胎儿中，右心系统发育异常20胎（20／27，74．07％），其中右心发育不良综合征13胎，肺动脉瓣狭窄并三尖瓣重度反流3胎，Ebstein畸形并三尖瓣重度反流2胎，三尖瓣黏液样变性并重度反流1胎，单纯肺动脉瓣轻度狭窄1胎；锥干畸形5胎（5／27，18．52％），其中右心室双出口2胎，永存动脉干1胎，法洛四联症1胎，功能矫正型大动脉转位1胎；扩张型心肌病l例；卵圆孔血流受限1例。结论静脉导管A波倒置高度提示胎儿右心系统发育不良或胎儿锥干畸形。

英文摘要：

Objective To explore the clinical significance of reversed A-wave in the fetal ductus venosus during the second- and the third-trimester. Methods Twenty-seven fetuses with reversed A-wave in the fetal ductus venosus were enrolled, and the features of cardiac abnormalities were analyzed with comparison to the results of autopsy and neonatal fol- low-up. Results Among all 27 fetuses, 20 fetuses （20/27, 74. 07%） had hypoplasia of right heart system, including 13 associated with hypoplastic right heart syndrome, 3 with pulmonary stenosis and severe tricuspid regurgitation （TR）, 2 with Ebstein anomaly and severe TR, 1 with myxomatous degeneration and severe TR, 1 with pulmonary valve stenosis. Five fetuses （5/27, 18.52%） were found with conotruncal anomalies, including 2 with double outlet right ventricle, 1 with persistent truneus arteriosus, 1 with tetralogy of Fallot, 1 with corrected transposition of the great artery. Additionally, there was 1 fetus with dilated cardiomyopathy and 1 fetus with restricted foramen ovale. Conclusion Reversed A-wave in fetal ductus venosus during the second- and third-trimester strongly suggest hypoplasia of right heart system and conotruncal abnormalities.