Long-term experience with the prenatal diagnosis of cardiac anomalies in high-risk pregnancies in a tertiary center

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Abstract

Background. The aim of this study was to analyze the role of the prenatal diagnosis of cardiac anomalies in our center. Methods. The data of 5540 pregnant women at risk for congenital heart disease and studied at fetal echocardiography between 1984 and 2002, with complete follow-up were retrospectively analyzed. Results. There was a progressive gradual increase in the number of cases examined per year; 670 fetuses (12% of the population) had congenital heart disease, 6.3% of the milder lesions were not detected. A cardiac arrhythmia was diagnosed in 284 fetuses. Extracardiac and chromosomal anomalies were associated in 23.7 and 14.6 % respectively. Recurrence of congenital heart disease was 4.1 %. One hundred and seventy-four patients (26 %) opted for pregnancy termination; of the 496 fetuses whose parents decided to continue with pregnancy, 10.1 % died in utero, 33.7 % postnatally and 56.2 % survived. The post-surgical mortality was 30.4 %. Negative prognostic factors were associated anomalies, heart failure and complex congenital heart disease. Twenty-nine out of 33 fetuses with persistent tachyarrhythmias treated in utero survived; fetuses with complex and isolated atrioventricular block had a 75 and 11.1 % mortality. Conclusions. Prenatal diagnosis was useful in the management of pregnancy and a planned birth and was life-saving in case of tachyarrhythmia.

Original languageEnglish
Pages (from-to)855-864
Number of pages10
JournalItalian Heart Journal
Volume4
Issue number12
Publication statusPublished - Dec 2003

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High-Risk Pregnancy
Prenatal Diagnosis
Fetus
Heart Diseases
Tachycardia
Pregnancy
Mortality
Atrioventricular Block
Family Planning Services
Echocardiography
Cardiac Arrhythmias
Pregnant Women
Heart Failure
Parents
Parturition
Recurrence
Population

Keywords

  • Arrhythmia
  • Congenital heart disease
  • Diagnosis
  • Echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{0cbad325bc7349b79bded1355d1677fb,
title = "Long-term experience with the prenatal diagnosis of cardiac anomalies in high-risk pregnancies in a tertiary center",
abstract = "Background. The aim of this study was to analyze the role of the prenatal diagnosis of cardiac anomalies in our center. Methods. The data of 5540 pregnant women at risk for congenital heart disease and studied at fetal echocardiography between 1984 and 2002, with complete follow-up were retrospectively analyzed. Results. There was a progressive gradual increase in the number of cases examined per year; 670 fetuses (12{\%} of the population) had congenital heart disease, 6.3{\%} of the milder lesions were not detected. A cardiac arrhythmia was diagnosed in 284 fetuses. Extracardiac and chromosomal anomalies were associated in 23.7 and 14.6 {\%} respectively. Recurrence of congenital heart disease was 4.1 {\%}. One hundred and seventy-four patients (26 {\%}) opted for pregnancy termination; of the 496 fetuses whose parents decided to continue with pregnancy, 10.1 {\%} died in utero, 33.7 {\%} postnatally and 56.2 {\%} survived. The post-surgical mortality was 30.4 {\%}. Negative prognostic factors were associated anomalies, heart failure and complex congenital heart disease. Twenty-nine out of 33 fetuses with persistent tachyarrhythmias treated in utero survived; fetuses with complex and isolated atrioventricular block had a 75 and 11.1 {\%} mortality. Conclusions. Prenatal diagnosis was useful in the management of pregnancy and a planned birth and was life-saving in case of tachyarrhythmia.",
keywords = "Arrhythmia, Congenital heart disease, Diagnosis, Echocardiography",
author = "Vlasta Fesslova and Laura Villa and Alessandra Kustermann",
year = "2003",
month = "12",
language = "English",
volume = "4",
pages = "855--864",
journal = "Italian Heart Journal",
issn = "1129-471X",
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TY - JOUR

T1 - Long-term experience with the prenatal diagnosis of cardiac anomalies in high-risk pregnancies in a tertiary center

AU - Fesslova, Vlasta

AU - Villa, Laura

AU - Kustermann, Alessandra

PY - 2003/12

Y1 - 2003/12

N2 - Background. The aim of this study was to analyze the role of the prenatal diagnosis of cardiac anomalies in our center. Methods. The data of 5540 pregnant women at risk for congenital heart disease and studied at fetal echocardiography between 1984 and 2002, with complete follow-up were retrospectively analyzed. Results. There was a progressive gradual increase in the number of cases examined per year; 670 fetuses (12% of the population) had congenital heart disease, 6.3% of the milder lesions were not detected. A cardiac arrhythmia was diagnosed in 284 fetuses. Extracardiac and chromosomal anomalies were associated in 23.7 and 14.6 % respectively. Recurrence of congenital heart disease was 4.1 %. One hundred and seventy-four patients (26 %) opted for pregnancy termination; of the 496 fetuses whose parents decided to continue with pregnancy, 10.1 % died in utero, 33.7 % postnatally and 56.2 % survived. The post-surgical mortality was 30.4 %. Negative prognostic factors were associated anomalies, heart failure and complex congenital heart disease. Twenty-nine out of 33 fetuses with persistent tachyarrhythmias treated in utero survived; fetuses with complex and isolated atrioventricular block had a 75 and 11.1 % mortality. Conclusions. Prenatal diagnosis was useful in the management of pregnancy and a planned birth and was life-saving in case of tachyarrhythmia.

AB - Background. The aim of this study was to analyze the role of the prenatal diagnosis of cardiac anomalies in our center. Methods. The data of 5540 pregnant women at risk for congenital heart disease and studied at fetal echocardiography between 1984 and 2002, with complete follow-up were retrospectively analyzed. Results. There was a progressive gradual increase in the number of cases examined per year; 670 fetuses (12% of the population) had congenital heart disease, 6.3% of the milder lesions were not detected. A cardiac arrhythmia was diagnosed in 284 fetuses. Extracardiac and chromosomal anomalies were associated in 23.7 and 14.6 % respectively. Recurrence of congenital heart disease was 4.1 %. One hundred and seventy-four patients (26 %) opted for pregnancy termination; of the 496 fetuses whose parents decided to continue with pregnancy, 10.1 % died in utero, 33.7 % postnatally and 56.2 % survived. The post-surgical mortality was 30.4 %. Negative prognostic factors were associated anomalies, heart failure and complex congenital heart disease. Twenty-nine out of 33 fetuses with persistent tachyarrhythmias treated in utero survived; fetuses with complex and isolated atrioventricular block had a 75 and 11.1 % mortality. Conclusions. Prenatal diagnosis was useful in the management of pregnancy and a planned birth and was life-saving in case of tachyarrhythmia.

KW - Arrhythmia

KW - Congenital heart disease

KW - Diagnosis

KW - Echocardiography

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