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Prenatally detectable congenital heart defects in Down syndrome fetuses.
MedLine Citation:
PMID:  21360623     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To document the incidence of congenital heart defects (CHD) detectable echocardiographically in the fetus with trisomy 21 and the relationship with nuchal translucency, fetal sex and ethnicity. METHODS: Fetuses with a karyotypic diagnosis of trisomy 21 were collected between January 2002 and March 2010. The data was analysed for the gestational age at examination, maternal age, reason for referral for fetal echo, the cardiac diagnosis, fetal sex, ethnicity and outcome. RESULTS: Of 917 fetuses with trisomy 21, 487 had a diagnostic echocardiogram. Cardiac examination was performed before 14 weeks gestation in 75% of cases. The reason for referral was increased nuchal thickness in 75%, suspected cardiac abnormality in 15% and an extracardiac anomaly in 6%. Structural CHD was found in 164/487 (34%), or 98/412 (24%) if those referred for suspected CHD are removed. The most common diagnosis was atrioventricular septal defect (AVSD) (115/487, 24%). Female fetuses with Down syndrome were twice as likely to have an isolated AVSD than males. There was no difference in the incidence of AVSD with ethnicity. The pregnancy continued in 36/487 cases. Of 10 intrauterine deaths, 6 had structural heart disease, of 23 live births, 15 had CHD (3 lost-to-follow-up). CONCLUSIONS: Most fetuses (66-76%) with trisomy 21 have a structurally normal heart on echocardiography. CHD did not additionally increase the measurement of nuchal translucency. The increased incidence of AVSD in females was confirmed in our study, although an ethnic difference could not be confirmed. CHD does not appear to increase the chance of spontaneous intrauterine loss in ongoing pregnancies. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
R Mogra; V Zidere; Ld Allan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-28
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
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