Perinatal management, counselling and outcome of fetuses with congenital heart disease

Seminars in Fetal & Neonatal Medicine
Mats Mellander

Abstract

Prenatal treatment options for fetal heart disease are still limited but pharmacological treatment of fetal tachyarrhythmias is usually effective. Prenatal catheter interventions are likely to be an option in selected fetal cardiac defects in the future. Delivery should be at a tertiary care centre if the need for immediate neonatal transport is anticipated. When a cardiac problem is diagnosed in a fetus, the parents should be counselled by a paediatric cardiologist specialized in fetal cardiology in close co-operation with the obstetric team. The rate of termination is influenced by gestational age at diagnosis, the severity of the heart defect and the presence of associated malformations. In fetuses with isolated cardiac malformations who are in sinus rhythm with good myocardial function and no or trivial atrioventricular valve regurgitation, the risk of spontaneous intra-uterine death is low. Prenatal echocardiography has the potential to improve postnatal survival in infants with critical heart defects, especially those with duct-dependent systemic or pulmonary circulations.

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Citations

May 31, 2014·Journal of Perinatology : Official Journal of the California Perinatal Association·C A WalshF M McAuliffe
Oct 12, 2012·Pediatric Cardiology·Benjamin J LandisIsmee A Williams
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Feb 16, 2017·Current Treatment Options in Cardiovascular Medicine·Caroline K Lee

Related Concepts

2D Echocardiography
Embryopathies
Heart Block
Cardiac Catheterization Procedures
Congenital Heart Defects
Pregnancy Outcome
Tachycardia
Fetal Ultrasonography

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