Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Poster Presentations: 8 Years of fetal echocardiography in high-risk mothers: The Birmingham Women’s Hospital experience

Introduction: Congenital heart disease (CHD) affects 8 per 1000 live births and it is also responsible for 20% of neonatal deaths. Antenatal diagnosis of major CHD allows appropriate counselling and planning for delivery at a neonatal unit with appropriate intensive care and transport facilities. Birmingham Women’s Hospital provides a supra-regional specialist fetal echocardiography in high-risk mothers. Aim: To evaluate fetal echocardiography findings in high-risk mothers over an 8 year period. Method: We undertook a retrospective review of all pregnant women at high-risk of having a baby with congenital heart disease who underwent fetal echocardiography between 01/01/1997 and 31/12/2004 at Birmingham Women’s Hospital. Results: 3,963 mothers were referred for fetal echocardiography and a total of 5,568 fetal echocardiography examinations were carried out during this period. The main reasons for referral were: (i) previously affected child – 27% (ii) abnormal initial screening scan – 20.7% (iii) maternal cardiac condition – 9.5% (iv) infant of diabetic mothers – 8% and (v) increased fetal nuchal translucency – 3%. Seven hundred and twleve (17.9%) echocardiograms were reported as abnormal. The majority of the abnormalities were identified in mothers who had abnormal initial screening scan (62%). In addition, the echocardiogram was also abnormal in 9% of cases with increased fetal nuchal translucency and in 5.7% of infants of diabetic mothers. In those with previously affected child and maternal cardiac condition, the echocardiogram was abnormal in 2.5% and 2.6% respectively. Conclusion: Abnormal initial screening scans and increased nuchal translucency had the highest yield in identifying CHD in high-risk mothers. Infant of diabetic mothers also have an increased risk warranting fetal cardiac screening for CHD. Normal fetal echocardiogram provides reassurance for the remainder of parents.

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Concordance Between Obstetric Anatomic Ultrasound and Fetal Echocardiography in Detecting Congenital Heart Disease in High‐risk Pregnancies

Journal of Ultrasound in Medicine ◽

10.1002/jum.15592 ◽

2020 ◽

Author(s):

Rahul Krishnan ◽

Laura Deal ◽

Christian Chisholm ◽

Briana Cortez ◽

Annelee Boyle

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

High Risk ◽

Congenital Heart ◽

Fetal Echocardiography

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Accuracy and limitations of transabdominal fetal echocardiography at 12-15 weeks of gestation in a population at high risk for congenital heart disease

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2000.tb11673.x ◽

2000 ◽

Vol 107 (12) ◽

pp. 1492-1497 ◽

Cited By ~ 39

Author(s):

John M. Simpson ◽

Annette Jones ◽

Nicky Callaghan ◽

Gurleen K. Sharland

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

High Risk ◽

Congenital Heart ◽

Fetal Echocardiography

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Screening for congenital heart disease in high-risk population: Indications for fetal echocardiography

Materia Medica ◽

10.5937/matmed1101252a ◽

2011 ◽

Vol 27 (1) ◽

pp. 252-261

Author(s):

Biljana Arsic ◽

Milan Perovic ◽

Eliana Garalejic ◽

Aleksandra Simic

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

High Risk ◽

Congenital Heart ◽

Fetal Echocardiography ◽

High Risk Population ◽

Risk Population

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Fetal echocardiography: Recognition and intrauterine treatment of fetal cardiac problems and prenatal diagnosis of congenital heart disease.

The Kurume Medical Journal ◽

10.2739/kurumemedj.34.147 ◽

1987 ◽

Vol 34 (3) ◽

pp. 147-163

Author(s):

NORIKO RIKITAKE ◽

HIROHISA KATO ◽

ON TOYODA ◽

KAZUSHIGE SUZUKI ◽

OSAMU INOUE ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Prenatal Diagnosis ◽

Congenital Heart ◽

Fetal Echocardiography ◽

Intrauterine Treatment

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Survival of Patients with High-Risk Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.06.12404 ◽

2021 ◽

Vol 104 (6) ◽

pp. 895-901

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

High Risk ◽

Congenital Heart ◽

First Year ◽

Pulmonary Arterial ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD) with uncorrected left-to-right shunts. Currently, no consensus guideline exists on the management of PAH-CHD in children, especially those who do not meet operability criteria. Objective: To compare survival between three groups of high-risk PAH-CHD, group 1: total correction including both surgical and percutaneous intervention, group 2: palliative treatment, and group 3: conservative with medical treatment group. Materials and Methods: All pediatric patients with PAH-CHD that underwent cardiac catheterization between January 1, 2008 and December 31, 2017 were retrospectively reviewed. Inclusion criteria were high risk PAH-CHD patients who had pulmonary vascular resistance (PVR) greater than 6 Wood unit·m² and PVR-to-SVR ratio greater than 0.3 evaluated in room air. Exclusion criteria were younger than three months of age, severe left side heart disease with pulmonary capillary wedge pressure greater than 15 mmHg, obstructive total pulmonary venous return, and single ventricle physiology. The Kaplan-Meier analysis was performed from the date of PAH diagnosis to the date of all-cause mortality or to censored date at last follow-up. Results: Seventy-six patients with a median age at diagnosis of 27.5 months (IQR 14.5 to 69.0 months) were included in this study. The patients were divided into three subgroups and included 38 patients (50.0%) in group 1, six patients (7.9%) in group 2, and 32 patients (42.1%) in group 3. The median follow-up time was 554 days (IQR 103 to 2,133 days). The overall mortality was 21.7%. One-year survival in patients with simple lesion in group 1 and 3 were 79.5% and 87.5% and patients with complex lesions in group 1, 2, and 3 were 93.8%, 83.3%, and 73.1%, respectively. The results showed that most mortalities occurred in the first year. There were no statistically significant differences in survival among difference types of treatment (log rank test, p=0.522). Conclusion: The mortality of high-risk PAH-CHD patients were not different among those who underwent corrective surgery, palliative, or conservative treatment. The mortality was high in the first year after PAH diagnosis and remain stable afterward. Management decision for an individual with high-risk PAH-CHD patients requires comprehensive clinical assessment to balance the risks and benefits before making individualized clinical judgment. Keywords: Pulmonary hypertension; Congenital heart disease; High-risk patients

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Abstract 16738: Association Between First and Second Trimester Maternal Screening Biochemistry, Ultrasound, and Fetal Brain Growth in Presence of Fetal or Maternal Congenital Heart Disease

Circulation ◽

10.1161/circ.142.suppl_3.16738 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Aman Sharma ◽

Emma Lewis ◽

Gabrielle Gray ◽

Jennifer R Maldonado ◽

Diana L Knoedel ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Fetal Brain ◽

Nuchal Translucency ◽

Second Trimester ◽

Fetal Head ◽

Placental Dysfunction ◽

Z Scores ◽

Hormonal Levels

Introduction: Newer research has highlighted significant neurological impairments in children and adults with congenital heart disease (CHD). The more severe the heart defect, the higher the neurologic impairment. Pregnancies complicated by fetal or maternal CHD carry a higher risk of placental abnormalities. We studied the association between pregnancy hormonal levels and fetal head and body growth. Hypothesis: Placental dysfunction in pregnancies with fetal or maternal CHD alters pregnancy hormonal levels affecting fetal brain and somatic growth. Methods: We performed a retrospective case-control study on pregnant women (year 2010-2019) at the University of Iowa. Only women with first and/or second trimester prenatal screening (ultrasound and blood test) were included. Pregnancies with fetal chromosomal abnormalities, multiple gestation, maternal diabetes, smoking, or hypertension were excluded. Pregnancies were either healthy controls (n=36), women with CHD (MCHD; n=26), or fetus with CHD (FCHD; n=23). Pregnancy hormonal levels, ultrasound findings, and fetal/neonatal growth percentiles and/or z-scores data were analyzed. Results: Women with CHD were younger (p=0.004) with increased fetal nuchal translucency (p=0.003) compared to controls. Women in MCHD (p=0.02) and FCHD (p=0.02) group delivered earlier than controls. FCHD had significantly lower pregnancy associated plasma protein-A (PAPP-A) levels than controls (p=0.04). The groups had no difference in the second trimester fetal head circumference (HC) and femur length. FCHD group had significantly smaller HC percentile (p=0.03) and z-scores (p=0.03) at birth than controls. Both FCHD and MCHD had smaller birth weight and length compared to controls. However, only FCHD group demonstrated significantly lower HC to birth weight ratio (p=0.01). The controls had a positive correlation between human chorionic gonadotropin level and head circumference z-score at birth (r=0.34;p=0.053). Conclusions: Pregnant women with CHD have increased fetal nuchal translucency and deliver at earlier gestational age. Women with fetal CHD have smaller neonatal head and body size at birth with associated low PAPP-A level early in their pregnancy probably related to placental dysfunction.

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