medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2007, Number 09

<< Back Next >>

Ginecol Obstet Mex 2007; 75 (09)

Prenatal diagnosis of fetal cardiac defect

Ochoa TMA, Hernández HRJ, Hernández GJ, Luna GSA, Padilla MYM

Language: Spanish
References: 22
Page: 509-514
PDF size: 223.82 Kb.


ABSTRACT

Introduction: The prevalence of congenital cardiac defects is 8 per 1000 neonates, and it’s different if high or low risk populations are studied. The fetal ultrasonographic increase prenatal detection but varies from 7 to 90%.
Objectives: To know the prevalence of fetal cardiopathy and detection in high risk pregnancies
Patients and methods: A observational study was made in pregnancies women with 16 old week of gestation.
Results: We received a total of 3500 high-risk pregnancies and were detected 112 cases with fetal cardiopathy (3.2%). The 30% of them had a risk factor of cardiopathy. The most frequent fetal cardiac defect detected were arrhythmia in 34 fetus, septal defects in 30, valvular defects in 17, hypoplasic or absence of cardiac cavities 16, tronco-conus defects 8, and other 7 included ectopia cordis 3, cardiac tumor 2, abnormal drainage of pulmonary veins 2. The diagnosis increased every year since started study. The prenatal diagnoses suspected in fetal echocardiography were confirmed in 80% of the cases in neonatal period.
Conclusion: The detection rate of fetal cardiac defect was 3.2% in high-risk pregnancies, four times higher than general population prevalence of congenital heart disease. We found a 30% overall perinatal mortality in fetal cardiac defect. The most frequent fetal cardiac defects found in this screening were arrhythmias and septal ventricular defects in almost 50% of patients.


REFERENCES

  1. Hoffman JI. Congenital Heart Disease: incidence and inheritance. Pediatr Clin North Am 1990;1:25-43.

  2. Fyfe DA, Kline CH. Fetal echocardiographic diagnosis of congenital heart disease. Pediatr Clin North Am 1990;1:45-67.

  3. Montana E, Khoury MJ, Cragan JD, Sharma S, et al. Trends and outcomes after prenatal diagnosis of congenital cardiac malformations by fetal echocardiography in a well defined birth population, Atlanta Georgia 1990-1994. J Am Coll Cardiol 1996;28:1805-9.

  4. Rustico MA, Benettoni A, D´Ottavio G, Maieron A, et al. Fetal heart screening in low risk pregnancies. Ultrasound Obstet Gynecol 1995;6:313-9.

  5. Sinclair BG, Sandor GG, Farquharson DF. Effectiveness of primary level antenatal screening for severe congenital heart disease: a population based assessment. J Perinatol 1996;16:336-40.

  6. Stumpflen I, Stumpflen A, Wimmer M, Bernaschek G. Effect of detailed fetal echocardiography as part of routine prenatal ultrasonographyc screening on detection of congenital heart disease. Lancet 1996;348:854-7.

  7. Buskens E, Grobbee DE, Frohn-Mulder IM, Stewart PA, et al. Efficacy of routine fetal ultrasound screening for congenital heart disease in normal pregnancy. Circulation 1996;94:67-72.

  8. Tegnander E, Eik-Nes SH, Johansen OJ, Linker DT. Prenatal detection of heart defects at the routine fetal examination at 18 weeks in a non-detected population. Ultrasound Obstet Gynecol 1995;5:372-80.

  9. Smith RS, Comstock CH, Kirk JS, Lee W. Ultrasonographic left cardiac axis deviation: a marker for fetal anomalies. Obstet Gynecol 1995; 85:187-91.

  10. Shipp TD, Bromley B, Hornberger LK, Nadel A, Benacerraf BR. Levorotation of fetal cardiac axis: a clue for the presence of congenital heart disease. Obstet Gynecol 1995;85: 97-102.

  11. Berning RA, Silverman NH, Villegas M, Sahan DJ, et al. Reversed shunting across the ductus arteriosus or atrial septum in utero heralds severe congenital heart disease. J Am Coll Cardiol 1996;27:481-6.

  12. Ott WJ. The accuracy of antenatal fetal echocardiography screening in high and low risk patients. Am J Obstret Gynecol 1995;172:1741-7.

  13. Buskens E, Grobee DE, Frohn MI, Wladimiroff JW, Hess J. Aspects of the aetiology of congenital heart disease. Eur Heart J 1995;16:584-7.

  14. Savio BA, Oliva RJ. Ecocardiografía fetal: evaluación y resultados de un programa nacional. Cuba 1989-1991. Rev Cubana Pediatr 1995;67(1).

  15. Knilans TK. Cardiac abnormalities associated with hydrops fetalis. Semin Perinatol 1995;19:483-92.

  16. Blake DM, Mastrogiannis D, Reece EA. Is a five step approach to fetal echocardiography feasible throughout pregnancy? Am J Perinatol 1995;12:290-3.

  17. Bhat AH, Sahn D. Latest advances and topics in fetal echocardiography. Curr Opin Cardiol 2004;19:97-103.

  18. Serrano GS, Bermluez SM, Palma HE, Del Castillo SL, et al. Ectopia cordis: manejo multidisciplinario con resultado exitoso. Ginecol Obstet Mex 2006;74:439-43.

  19. Lazalde B, Sanchez Urbina R, García de Alba JE, Ramirez Dueñas ML. Diabetes mellitus gestacional y malformaciones congénitas. Ginecol Obstet Mex 2001;69:399-405.

  20. Gaxiola CR, Gamboa R, Fajardo DS, Castellanos GJ, Gaona FR. Polydramnios and its relationship with congenital malformations. Ginecol Obstet Mex 1995;63:505-8.

  21. Garcia RF, Hicks GJ. Prenatal diagnosis by ultrasonography. A randomized study of 3000 patients. Ginecol Obstet Mex 1991;59:323-327.

  22. Deng J, Rodeck C. Current applications of fetal cardiac imaging technology. Curr Opin Obstet Gynecol 2006; 18: 177-184.




2020     |     www.medigraphic.com