Document Detail

Fetal complete heart block: antenatal diagnosis, significance and management.
MedLine Citation:
PMID:  2653898     Owner:  NLM     Status:  MEDLINE    
Complete heart block was diagnosed prenatally in 21 fetuses. Associated structural cardiac defects were present in 18 fetuses, in particular complete atrioventricular canal with atrial isomerism (5 cases), and 'corrected' transposition of the great arteries (4 cases). Maternal systemic lupus erythematosus was proved in only one case. In 11 fetuses, intra-uterine congestive heart failure with the signs of non-immune hydrops fetalis occurred. In all 11 fetuses, the hydrops was associated with a cardiac defect, in particular complete atrioventricular canal with atrial isomerism in 5 cases. A review of the literature confirms that only the association of complete heart block and cardiac malformation can cause intra-uterine congestive heart failure, whereas in the case of fetal complete heart block without cardiac malformation or with prenatally hemodynamically insignificant cardiac malformation, congestive heart failure is rare. Only 30% of newborns with complete heart block have associated cardiac malformations. In our series, however, 86% of the fetuses with complete heart block had cardiac malformations. The most important reason for this percentage discrepancy is that almost all fetuses with associated severe cardiac defects, in particular atrioventricular canal defects, develop heart failure which frequently results in prenatal death. Thus, fetal deaths are not included in pediatric statistics. Nevertheless, fetuses with isolated complete heart block generally do not develop heart failure and in almost all of the cases are born alive.
U Gembruch; M Hansmann; D A Redel; R Bald; G Knöpfle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  31     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  1989 Apr 
Date Detail:
Created Date:  1989-06-12     Completed Date:  1989-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  9-22     Citation Subset:  IM    
Department of Prenatal Diagnosis and Therapy, University of Bonn, F.R.G.
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MeSH Terms
Fetal Diseases / diagnosis*,  surgery
Heart Block / diagnosis*,  surgery
Heart Defects, Congenital / diagnosis,  surgery
Heart Failure / diagnosis
Infant, Newborn
Prenatal Diagnosis
Prospective Studies

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