Document Detail


Etiology and outcome of fetuses with functional heart disease.
MedLine Citation:
PMID:  15144333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to assess the etiology and outcome of fetuses with functional heart disease as detected by echocardiography. METHODS: In total, 51 fetuses (median gestation age of 28.6 weeks) were included. The inclusion criteria were hydrops (n = 14), pericardial effusion (PE; n = 9), tricuspid valve regurgitation (TR; n = 8), hypertrophic cardiomyopathy (HCM; n = 7) and dilated cardiomyopathy (DCM; n = 7). Antenatal management was performed for 17 of 51 fetuses (33%): two abortions, nine digoxin administrations, three thoracocenteses, one pericardial puncture, one blood transfusion and one ascites centesis. RESULTS: The etiology of functional heart disease was twin pregnancy in 18, fetal lung lesions in five, maternal diabetes in five, fetal anemia in four, extracardiac or chromosomal abnormalities in three, infection in three, teratoma or arteriovenous malformation in four, indomethacin administration in two, endocardial fibroelastosis in two, maternal anaphylaxia in one, idiopathic arterial calcification of infancy (IACI) in one, pregnancy-induced hypertension (PIH) in one, and unknown in two fetuses. There was no significant difference between fetuses with and without treatment (53% vs. 79%; p = 0.06). There were two stillbirths and 12 postnatal deaths (29%). Among 35 surviving infants, 85% were free of symptoms in the follow-up (mean 3.9 years). CONCLUSIONS: These findings indicate that a functional heart disease in utero is associated with very varying etiology and high mortality. Improved understanding of the hemodynamic findings may lead to treatment that is more successful.
Authors:
Talvikki Boldt; Sture Andersson; Marianne Eronen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  83     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-17     Completed Date:  2004-06-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  531-5     Citation Subset:  IM    
Affiliation:
Hospital for Children and Adolescents, Helsinki University Hospital, Helsinki, Finland. talvikki.boldt@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography
Female
Finland / epidemiology
Gestational Age
Heart Defects, Congenital / embryology,  epidemiology*,  etiology,  ultrasonography*
Humans
Pregnancy
Pregnancy Outcome
Pregnancy, Multiple
Ultrasonography, Prenatal*

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