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Echocardiographic follow-up and pregnancy outcome of fetuses with cardiac asymmetry at 18-22 weeks of gestation.
MedLine Citation:
PMID:  24760774     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The goal of our study was to evaluate the evolution of cardiac findings and assess the pregnancy outcome of fetuses with cardiac asymmetry at mid-gestation.
METHODS: We reviewed all fetuses with cardiac asymmetry at echocardiograms performed at 18-22 weeks of gestation from 2006 through 2013. The data collected included the gestational age at diagnosis, serial echocardiographic findings, karyotype testing, and pregnancy outcome. Excluded were cases of classical HLHS at initial echocardiogram (i.e. aortic and/or mitral atresia or dysplasia with normal intracardiac connections), heterotaxy syndrome, twin pregnancy, fetal growth restriction, and coarctation of the aorta.
RESULTS: Our study included 278 fetuses with cardiac asymmetry (defined as Z-scores of left ventricle length or diameter < -2) . 202 (72%) fetuses had normal variations in cardiac growth by prenatal and neonatal echocardiography, 69 (25%) fetuses were confirmed to have hypoplastic left heart syndrome (HLHS) variant by autopsy or neonatal echocardiography (with an overall survival of 4.3%), and 7 (3%) fetuses were terminated before 24 weeks of gestation because of abnormal karyotypes. None of the cardiac measurements at the initial echocardiogram was significantly different between HLHS variant and normal cases. In the 69 fetuses ultimately diagnosed with HLHS variant, but not the in 202 normals, the Z-scores of all measured left heart structures decreased progressively between the first and last prenatal echocardiograms (P < 0.01).
CONCLUSIONS: The majority of the fetuses with cardiac asymmetry at 18-22 weeks have a good outcome. A minority of them progress to develop HLHS variant with advancing gestation. This article is protected by copyright. All rights reserved.
Authors:
Jiawei Zhou; Qichang Zhou; Ming Zhang; Shi Zeng; Qinghai Peng; Leiqi Tian
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-24
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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