Document Detail


Atrioventricular septal defect recently diagnosed by fetal echocardiography: echocardiographic features, associated anomalies, and outcomes.
MedLine Citation:
PMID:  18377486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We report our recent experience with atrioventricular septal defect (AVSD) diagnosed in utero.
METHODS: We reviewed fetal echocardiograms diagnosed with AVSD between November 2002 and November 2004, comparing fetuses with and without aneuploidy. We compared results with previous studies.
RESULTS: Twenty (1.8%) fetuses had AVSD. Mean maternal age was 33 years (range 19-43). Mean gestational age was 26 weeks (range 18-38). Indications for fetal echocardiography were: abnormal obstetrical ultrasound (75%), chromosomal anomaly (15%), undetermined (10%). AVSD was an isolated cardiac defect in 5 (25%), associated with double-outlet right ventricle (9) or tetralogy of Fallot (3) in 12 (60%). Four had aortic arch anomalies. Atrioventricular valve regurgitation was mild in 7 (35%) and moderate in 4 (20%). Heart block existed in 2 (10%). Five (25%) with trisomy had Rastelli type A AVSD as a single lesion (odds ratio 24, P < .01). Extracardiac anomalies existed in 6, with and without aneuploidy. Pregnancy was terminated in 4 (20%), neonatal death in 4 (20%), and reparative surgery in 6 (30%), not ascertained in 6.
CONCLUSION: Atrioventricular septal defect is usually an isolated cardiac lesion in fetuses with aneuploidy. In the absence of aneuploidy, fetal AVSD is often associated with conotruncal and aortic arch abnormalities, which are important in determining outcomes. Pregnancy termination and neonatal death continue to be prevalent.
Authors:
Mark K Friedberg; Nancy Kim; Norman H Silverman
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  2     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2007 Mar-Apr
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-06-19     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  110-4     Citation Subset:  IM    
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, CA 94304, USA.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / mortality,  ultrasonography*
Abortion, Induced
Adult
Aneuploidy*
Aorta, Thoracic / abnormalities
Female
Heart Block / complications
Heart Defects, Congenital / mortality,  ultrasonography*
Heart Septal Defects, Atrial / genetics*,  ultrasonography*
Heart Septal Defects, Ventricular / genetics*,  ultrasonography*
Heart Valve Diseases / complications
Humans
Infant, Newborn
Pregnancy
Ultrasonography, Prenatal*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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