Perinatal management of fetal cardiac anomalies in a specialized obstetric-pediatrics center

American Journal of Perinatology
V MirlesseF Daffos

Abstract

Perinatal teams dealing with fetal heart disease frequently wonder which pregnancies might be terminated, and when delivery should take place in a specialized surrounding. We present a retrospective study of 229 fetuses, in which prenatal ultrasound showed a cardiac anomaly not compatible with a standard maternity ward delivery. One hundred nineteen pregnancies were terminated (group I) while 110 pregnancies led to the birth of a live baby (group II). Pathology in group I was discovered earlier than in group II (24 vs. 29.3 weeks' gestation; p <0.01), and associated malformations or chromosomal anomalies were much more frequent in group I (80/119 vs. 9/110; p <0.001). Among live born babies, three infants with transposition of the great arteries underwent Rashkind atrioseptostomy in the delivery room. With a minimum follow-up of 12 months, 69 children (63%) have undergone surgery. Among 92 survivors (1 child is lost to follow-up), 78 (71%) are asymptomatic and 14 symptomatic. Early prenatal diagnosis of fetal heart anomalies significantly facilitates prenatal work-up and perinatal care. We present the types of pathology having led to termination and define the situations in which children are at risk of perinatal hemodynamic co...Continue Reading

Citations

Jan 8, 2013·The American Journal of Cardiology·Mary T DonofrioJohn T Berger
Jun 9, 2009·Pediatric Clinics of North America·Anand K RajaniLouis P Halamek
Aug 25, 2015·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Mary T DonofrioCraig A Sable
Apr 1, 2015·Seminars in Fetal & Neonatal Medicine·Jay D PruetzDavid A Miller
Nov 29, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Takekazu MiyoshiTomoaki Ikeda
Apr 26, 2014·Circulation·Mary T DonofrioAmerican Heart Association Adults With Congenital Heart Disease Joint Committee of the Council on Cardiovascular Disease in
Aug 4, 2006·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·S YagelL Fermont
Dec 28, 2006·Prenatal Diagnosis·Hilmar H BijmaJuriy W Wladimiroff
Jan 13, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·George E SarrisPascal R Vouhé

Related Concepts

Abortion, Selective
Autosome Abnormalities
Congenital Heart Defects
Obstetrics Department Hospital
Outcome and Process Assessment (Health Care)
Perinatology
Antenatal Screening Procedures
Patient Referral
Retrospective Studies
Family Planning Program Evaluation

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