本邦における胎児先天性心疾患への出生前治療介入について：より良い出生後治療につなげるために

Abstract

In recent years, fetal ultrasound screening has become widespread, leading to most congenital diseases being diagnosed prenatally. Nonetheless, some cases still progress to fetal heart failure leading to fetal death during their uterine period, while others with congenital heart disease (CHD) still experience severe deterioration, making survival di cult even with intensive postnatal therapy. Various prenatal interventions for these diseases have been implemented mainly in Europe and the United States, and there are many reports concerning their outcomes and e ects on prognostic improvement. In Japan, clinical studies and trials on fetal interventions for severe CHD (e.g., treatments for fetal arrhythmias and severe aortic valve stenosis) have continued to be conducted and steadily implemented. Conversely, there have yet been no reports in Japan on the administration of nonsteroidal anti-in ammatory drugs for Ebstein disease with circular shunt, which can advance in the near future. ere are ethical issues surrounding maternal and fetal health and the medical insurance system that need to be addressed through multidisciplinary collaboration. Nonetheless, we expect our fetal cardiac interventions and therapies to be able to match international standards.