To assess the fetal outcome of three hypertensive women exposed to amlodipine. 5 mg/day, in the first trimester of pregnancy. CASE 1: The patient was treated with amlodipine until 7 weeks of gestation. She was also exposed to levosulpiride, aluminum hydroxide gel, magnesium carbonate, and Ginkgo biloba. At 38(+3) weeks ...

Hypertrophic obstructive cardiomyopathy represents a genetic disorder characterized by hypertrophy, usually asymmetrical, of the ventricular musculature at the base of the septum in the left ventricular efflux tract. Patients suffering from this disorder can be extremely sensitive to small alterations in ventricular volumes, arterial pressure, cardiac frequency and rhythm. This ...

Fetal cardiac time intervals (fCTI) are dependent on fetal growth and development, and may reveal useful information for fetuses affected by growth retardation, structural cardiac defects or long QT syndrome. Fetal cardiac signals with a signal-to-noise ratio (SNR) of at least 15 dB were retrieved from fetal magnetocardiography (fMCG) datasets ...

OBJECTIVES: To investigate whether fetal cardiac axis is affected by the presence of an abdominal wall defect (AWD) independent of congenital heart disease (CHD). METHODS: Video ultrasound records from fetuses with AWDs identified from 1991-2004 were reviewed. Still images of the fetal cardiac four-chamber view were digitized and two independent ...

During pregnancy, healthy women develop ventricular hypertrophy and diastolic dysfunction as a result of volume overload as well as increased stretch and force demand. Pregnancy also induces electrocardiogram disturbances such as longer QT-interval dispersion. Surprisingly, it was not until recently that the underlying molecular mechanisms or the role of sex ...

Primary cardiac sarcoma is a rare disease in adults. It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential. The coincidence of pregnancy and a primary cardiac intimal sarcoma is extremely rare. We report a pregnant woman at 27(+5) weeks gestation who was ...

Peripartum cardiomyopathy is a rare and potentially lethal cardiac complication of pregnancy occurring in the final month of pregnancy through the first 5 months after birth. It is characterized by the development of congestive heart failure and left ventricular systolic dysfunction, in previously healthy women with no other identifiable cause ...

OBJECTIVES: The purpose of this study was to assess the pregnancy-related cardiovascular risk in LQT1 patients. BACKGROUND: Only 1 study addressed this issue in genotyped patients and reported that the highest risk is for LQT2 patients. METHODS: This case-control study, performed in a cohort of patients from 22 families affected ...

BACKGROUND: Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive fibrous or fibrofatty tissue replacement of the right ventricular myocardium. Interspersed adipocytes and fibrous tissue may provide foci for arrhythmias. The clinical spectrum of ARVD may include asymptomatic premature ventricular complexes to ventricular tachycardia and sudden death. There is currently ...

Improvements in health care services in recent decades have permitted more frequent identification of pregnant women with congenital and acquired heart disease. Normal pregnancy and the peripartum period are associated with considerable cardiocirculatory changes, which are usually well tolerated by the mother. However, the increased cardiac demands imposed by those ...

BACKGROUND: Fetal magnetocardiography is a noninvasive technique capable of identifying fetal arrhythmias and can simultaneously characterize the cardiac rhythm of the mother and fetus. CASES: Three patients, two singleton pregnancies and one twin pregnancy, were admitted for evidence of fetal supraventricular tachycardia. Fetal magnetocardiography was used to monitor the effects ...

A fetus presented with a large pericardial effusion caused by a right atrial transmural tumor. Correct prenatal diagnosis by use of targeted fetal echocardiography indicated that treatment was not required until the gestational age of 36 weeks. At that time, cesarean section was performed because early signs of imminent cardiac ...

OBJECTIVE: To determine the clinical and echocardiographic profiles of women with peripartum cardiomyopathy and ascertain the natural course of the disease. METHODS: Fifty-six women with peripartum cardiomyopathy were followed up for a mean period of 6.1 years and their clinical and echocardiographic profiles were studied as well as their outcomes. ...

Increasingly, women born with complete transposition of the great arteries who have undergone atrial repair by either the Senning or the Mustard procedure are reaching childbearing age. This study reports on pregnancy outcomes after the atrial repair of transposition of the great arteries. Record review and standardized questionnaires were used ...

BACKGROUND: Information on the outcome of pregnancy in patients with pulmonary valvar stenosis is scarce, mostly limited to cardiac complications observed during pregnancy. OBJECTIVES: To investigate the magnitude and determinants of non-cardiac and fetal risks during pregnancy of women with isolated pulmonary valvar stenosis. METHODS: Using the nationwide registry (CONgenital ...

OBJECTIVE: We have reported previously that valve dilation enhances growth of cardiac structures and may prevent hypoplastic left heart syndrome (HLHS) in fetuses with critical aortic stenosis. We aimed to investigate maternal/fetal factors which may affect the technical success of fetal valvuloplasty, and to describe perinatal complications of the procedure. ...

OBJECTIVE: To assess the maternal central haemodynamics in normotensive women with pregnancies complicated by severe fetal growth restriction (FGR). DESIGN: Cross-sectional study. SETTING: A tertiary referral fetal medicine unit. POPULATION: The study groups comprised 107 women with normal singleton pregnancies and 20 with singleton pregnancies complicated by FGR at 25-37 ...

Persistent fetal bradycardia noted in the antenatal period can occur secondary to maternal conditions, fetal cardiac structural defects, or from congenital heart block. Fetal bradycardia can be mistaken for maternal pulse and should be confirmed with ultrasound whenever possible. Prompt evaluation of the fetus with bradycardia can lead to early ...

Information on pregnancy and delivery in women with biventricular repair for isolated noncomplex pulmonary atresia with a ventricular septal defect (PAVSD) is limited. Using a nationwide congenital heart disease registry (CONgenital CORvitia [CONCOR]), 9 women with biventricular repair for PAVSD (aged 21 to 38 years) were identified. Ten pregnancies were ...

Beyond evaluating physiologic alterations encountered during pregnancy quantitative pulsed- and continuous Doppler and qualitative color Doppler technology can be used for cardiovascular assessment of the pregnant woman with heart disease or suspected cardiac abnormality. Echocardiography provides information about disease etiology, leads to accurate and non- invasive assessment of disease severity ...

We present a case with prenatal diagnosis of an intracranial high-flow pial arteriovenous fistula that was draining into the vein of Galen in the third trimester of pregnancy. The child was treated by transcatheter embolization with N-butyl 2-cyanoacrylate (NBCA) via the umbilical artery in the early neonatal period due to ...

OBJECTIVES: Mutations in the tafazzin (TAZ) gene at chromosomal locus Xq28 are responsible for Barth syndrome (BTHS), X-linked endocardial fibroelastosis (EFE), X-linked fatal infantile dilated cardiomyopathy (CMD3A), and familial isolated noncompaction of left ventricular myocardium (INVM). This evaluation was performed to determine if a known familial TAZ gene mutation might ...

OBJECTIVE: To evaluate the feasibility of obtaining standard echocardiographic views of the fetal heart during routine first-trimester screening and construct reference ranges for cardiac biometry at 11 + 0 to 13 + 6 weeks of gestation. METHODS: A cross-sectional study of 584 fetuses in an unselected population. Viable pregnancies with ...

I have always reassured my patients that taking selective serotonin reuptake inhibitors (SSRIs) during pregnancy would not increase their risk of having children with major malformations. A recent warning from Health Canada, based on results of a study from GlaxoSmithKline, stated that infants exposed to paroxetine might be at higher ...

OBJECTIVES: To investigate the accuracy of measurement of the atrial septal defect (ASD)area and dynamic change by live three-dimensional echocardiography (L3DE). METHODS: L3DE was performed in patients with ASD using a three-dimensional workstation to obtain the en face view of the ASD and measure its area at the peak of ...

In women with heart disease, sustained arrhythmias can result in an increased risk to the mother and fetus. The purpose of this study was to determine the recurrence rates of arrhythmias during pregnancy in women with cardiac rhythm disorders and examine the impact on fetal and neonatal outcomes. Women with ...

Emerging evidence demonstrates that heart disease may originate during fetal development. This review will focus on the role of maternal nutrition in the development of the fetal cardiovascular system. Emphasis will be placed upon the concept that nutritional inadequacies during gestation may be major programming stimuli that alter fetal cardiac, ...

OBJECTIVE: Fetal tachyarrhythmia may cause fetal hydrops and lead to fetal morbidity and mortality. Supraventricular tachycardia and atrial flutter have been the most diagnosed. We present a case of fetal atrial flutter diagnosed during the second trimester treated with digoxin and sotalol and delivered at term. CASE REPORT: A 30-year-old ...

Fetal cardiac calcifications are defined as diffuse hyperechogenicities in the different layers of the heart. This is an uncommon fetal ultrasound finding associated with significant myocardial dysfunction. We report four cases with massive fetal myocardial calcifications detected on prenatal ultrasound at 18-22 weeks' gestation and associated, in all cases, with ...

AIM: Using new real-time 3-D fetal echocardiography with instantaneous volume-rendered display, we evaluated the heart anatomy of a number of normal fetuses during pregnancy. METHODS: Eighteen normal fetuses in 17 pregnancies (16 singletons and one twin) at 18-38 weeks' gestation were studied using a transabdominal real-time 3-D ultrasound machine. This ...

BACKGROUND: Pregnant women with congenital heart disease are at increased risk for cardiac and neonatal complications, yet risk factors for adverse outcomes are not fully defined. METHODS AND RESULTS: Between January 1998 and September 2004, 90 pregnancies at age 27.7+/-6.1 years were followed in 53 women with congenital heart disease. ...

Because there is a paucity of information regarding the diagnosis and outcomes of fetal heterotaxy syndrome (HS), this study sought to determine the spectrum of cardiac pathology, accuracy of diagnosis, and outcome of fetal HS. All cases of fetal HS encountered in the investigators' institution over a 10-year period through ...

A ruptured sinus of Valsalva aneurysm is a rare cardiac anomaly, usually of a congenital nature. There are few documented cases of this condition during pregnancy, which renders unclear the therapeutic options. We report the case of a 35-year-old pregnant woman who presented at the hospital for cardiac evaluation due ...

OBJECTIVES: To determine the prevalence of 1st and 2nd degree AV block in fetuses with an irregular cardiac rhythm, and to summarize outcome of these pregnancies. Background: The diagnosis of irregular cardiac rhythm or 'skipped beats' includes isolated ectopy that resolves spontaneously. Recently, Doppler measurements of the 'mechanical' PR interval ...

As increasing numbers of children with congenital heart disorders reach adulthood, the family physician, cardiologist, and obstetrician will increasingly be called upon to give advice regarding the safety of pregnancy. This need has been further highlighted by the recognition that maternal mortality associated with cardiac disease is rising. Unfortunately, this ...

Cardiac disease complicates approximately 1% to 3% of pregnancies and is responsible for 10% to 15% of maternal mortality. The number of women of childbearing age with congenital disease is increasing as advances in diagnosis and treatment improve survival rates and overall health, allowing successful pregnancy. Pregnant women with severe ...

Beta-thalassemia major is a severe, transfusion-dependent anemia that also causes infertility due to iron deposition to endocrine organs after overtransfusion. Very few pregnancies have been reported among such patients after modern therapies. In this study, 32 women with thalassemia who were admitted to Ali Asghar Children's Hospital and Thalassemia Clinic ...

OBJECTIVES: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a cardiac disease characterised by myocardial necrosis followed by fibro-fatty substitution leading to the onset of ventricular arrhythmias. The aim of the present study was to analyse pregnancy in women affected by this condition. STUDY DESIGN: Six women affected by ARVC/D who underwent ...

Listeria monocytogenes is an alimentary infection which can be extremely dangerous for pregnant women. A 34-year-old pregnant woman was hospitalized with fetal cardiac rate alterations and influenza-like symptoms. A caesarean section due to fetal distress was performed. A maternal-fetal listeriosis diagnosis was possible only after the birth through bacteriological and ...

(1) Bupropion, which is also called amfebutamone, is an amphetamine marketed to assist with smoking withdrawal. (2) A registry of pregnancies exposed to bupropion has shown a higher-than-expected frequency of neonatal cardiac malformations: 7 of the 10 newborns with malformations had cardiac anomalies (70% of malformations), compared to about 25% ...

This review has tried to update our view of TS, highlighting the less severe phenotype we are seeing today, aiming to motivate clinicians to scrutinize normal looking short girls more closely, and to provide more relevant information for those counseling prospective parents on the implications of a TS karyotype during ...

BACKGROUND: Fetal magnetocardiography (fMCG) records fetal cardiac electro-physiological activity during the second half of gestation. We aimed at assessing normality values, related variability, and trends of fetal cardiac time intervals (fCTI) evaluated longitudinally from beat-to-beat fMCG analysis in uncomplicated pregnancies. MATERIALS AND METHODS: The fMCG were recorded with multi-channel system ...

This article discusses the unique properties of the fetal cardiovascular system and patterns of blood flow in congenital heart disease. It also explores the complex interactive dependency between the developing heart and pulmonary vasculature, with particular attention to hypoplastic left heart syndrome. The article goes on to highlight some recent ...

Because of insufficient imaging by maternal transabdominal fetal echocardiography (TAE) in a human fetus with aortic atresia, imperforate atrial septum and progressive cardiac failure, we assessed the feasibility of fetal transesophageal echocardiography (TEE) as a monitoring tool during fetal cardiac intervention at 24 + 6 weeks of gestation. Percutaneous fetoscopic ...

BACKGROUND: Foetal echocardiography has become a diagnostic method to detect foetal congenital heart disease with high probability. However, it is not only time consuming and but also difficult to visualize outflow tract of foetus early in the second trimester of pregnancy, even for an experienced obstetric ultrasonographer. Recently, many methods ...

We present a case of fetal tricuspid valve dysplasia, which was diagnosed at 22 weeks of gestation during a routine obstetrical examination. Serial fetal echocardiographic evaluation revealed progressive right ventricular outflow tract obstruction and persistent cardiomegaly. A female infant weighing 1,916 g was delivered by elective cesarean section at 38 ...

The Fontan procedure is performed for patients with a hypoplastic right ventricle, and pregnancies following this palliative surgery are likely to increase. We present a parturient with the Fontan physiology who successfully underwent two consecutive caesarean deliveries; the first under general anaesthesia for emergency surgery and the second under regional ...

Fetal echocardiography has been accepted as a prenatal noninvasive diagnostic tool of cardiovascular diseases in fetuses for more than three decades. There are limited data in Thailand. A retrospective study of prenatal, natal and postnatal data of pregnant women who had fetal echocardiography at Siriraj Hospital, Bangkok, Thailand, from January ...

OBJECTIVES: Z-scores for cardiac dimensions are well established in postnatal life, but have yet to be developed for fetal cardiac dimensions. These would be of real advantage to the clinician in accurately quantifying size and growth of cardiac dimensions and to the researcher by allowing mathematical comparison of growth in ...

BACKGROUND: Isomerism is associated with a complex spectrum of anomalies. There is paucity of data on prenatally detected cases. METHODS AND RESULTS: Between January 1990 and February 2004, 83 of 166 cases (50%) had a prenatal diagnosis of left isomerism (LAI; 52 of 97) or right isomerism (RAI; 31 of ...