scholarly journals First trimester fetal heart evaluation. A pictorial essay

2020 ◽  
Author(s):  
Ioana Cristina Rotar ◽  
Daniel Mureșan ◽  
Claudiu Mărginean ◽  
Claudiu Mărginean ◽  
Dominic Gabriel Iliescu ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Fetal Heart ◽  
First Trimester ◽  
Second Trimester ◽  
Doppler Examination ◽  
Examination Protocol ◽  
Evaluation Protocol ◽  
Pictorial Essay

Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data suggest that the diagnosis of congenital heart disease is feasible in the first trimester (FT) of pregnancy, especially for trained examiners. In this pictorial essay we aim to illustrate in detail the particularity of the FT heart evaluation: the specific ultrasound techniques including practical tips for the basic and extended first trimester fetal heart evaluation protocol. The diagnosis is possible by the use of a variety of ultrasound techniques (B mode, CFM, Bidirectional Doppler, STIC, TUI) using the transabdominal/transvaginal probes. An abnormal FT heart scan requires second trimester reassessment. Unfortunately, not all cardiac disease can be potentially diagnosed in the first trimester. Based on their own experience the authors recommend that heart examination in the FT should be attempted in all fetuses, even in low risk pregnancies, using at least the basic Doppler examination protocol.

scholarly journals Clinical scope of early fetal echocardiography

2021 ◽  
Author(s):  
Ximena Carolina Romero Infante ◽  
Arturo Montaño Mendoza ◽  
Diana Sarmiento ◽  
María Uriel Calvo ◽  
José De la Hoz Valle
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Echocardiography ◽  
Meta Analysis ◽  
Pulmonary Veins ◽  
First Trimester ◽  
Second Trimester ◽  
Congenital Heart Malformations ◽  
Cardiac Evaluation

The chances of detecting congenital heart disease are improved following structured protocols. Fetal heart disease is one of the main serious congenital malformations. The objective of this review is to present the benefits of sequential and routine cardiac evaluation in the first and early second trimesters and to identify the structures and pathologies that can be detected at this gestational age. The databases of PubMed, Medline, MD consult, Embase, Clinical Key, Scielo, and ScienceDirect, as well as specialized texts in Spanish and English were searched for diagnostic studies, systematic reviews, and meta-analysis related to the terms “early fetal echocardiography” and “congenital heart malformations” published between 2000 and 2019. Technological advances have revolutionized the fetal echocardiographic examination making possible the diagnosis of congenital heart disease from the first and early second trimester of pregnancy. However, it should be recognized that early fetal echocardiography has limitations such as the evaluation of pulmonary veins and cardiac lesions that are progressive. The benefit found was earlier detection of pathologies with high sensitivity and specificity. A fetal cardiac evaluation sequence was included in these early fetal echocardiographic examinations due to the awareness of fetal anatomical and hemodynamic differences in the first trimester and the beginning of the second trimester. Early fetal echocardiography is a very useful tool for the detection of congenital heart disease; it allows parents to be informed about the prognosis and possible treatments early. Fetal cardiac examination in the first trimester is safe and can detect the most of heart congenital malformation.

scholarly journals Analysis of commonly expressed genes between first trimester fetal heart and placenta cell types in the context of congenital heart disease

2022 ◽  
Author(s):  
Rebecca Wilson ◽  
Victor Yuan ◽  
Jennifer Alexander Courtney ◽  
Alyssa Tipler ◽  
James Cnota ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Endothelial Cells ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Heart ◽  
Reduction Process ◽  
Cell Types ◽  
First Trimester ◽  
Cellular Respiration ◽  
Oxidation Reduction

Congenital heart disease (CHD) is often associated with fetal growth abnormalities. During the first trimester of pregnancy, the heart and placenta develop concurrently, and share key developmental pathways. Hence, it is hypothesized that defective morphogenesis of either organ is synergistically linked. However, many studies determined to understand the mechanisms behind CHD overlook the contribution of the placenta. In this study, we aimed to identify commonly expressed genes between first trimester heart and placenta cells using two publicly available single cell sequencing databases. Using a systematic computational approach, we identified 328 commonly expressed genes between heart and placenta endothelial cells and enrichment in pathways including Vasculature Development (GO:0001944, FDR 2.90E-30), and Angiogenesis (GO:0001525, FDR 1.18E-27). We also found, in comparison with fetal heart endothelial cells, 197 commonly expressed genes with placenta extravillous trophoblasts, 128 with cytotrophoblasts and 80 with syncytiotrophoblasts, and included genes such as FLT1, GATA2, ENG and CDH5. Finally, comparison of first trimester cardiomyocytes and placenta cytotrophoblasts revealed 53 commonly expressed genes and enrichment in biological processes integral to cellular function including Cellular Respiration (GO:0045333; FDR 5.05E-08), Ion Transport (GO:0006811; FDR 2.08E-02), and Oxidation-Reduction Process (GO:0055114; FDR 1.58E-07). Overall, our results identify specific genes and cellular pathways common between first trimester fetal heart and placenta cells which if disrupted may concurrently contribute to the developmental perturbations resulting in CHD.

scholarly journals Ultrasound Patterns in the First Trimester Diagnosis of Congenital Heart Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3206
Author(s):  
Catalin G. Herghelegiu ◽  
Anca Maria Panaitescu ◽  
Simona Duta ◽  
Ana Maria Vayna ◽  
Anca Marina Ciobanu ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Heart ◽  
Color Doppler ◽  
First Trimester ◽  
American Institute ◽  
Color Doppler Flow ◽  
First Trimester Of Pregnancy ◽  
And Child Health

Congenital heart disease (CHD) is the most common birth defect, with a reported prevalence of 5–12 per 1000 live births. Very recently, the American Institute of Ultrasound in Medicine published a guideline recommending the use of the four-chamber and the three-vessel and trachea views to screen for CHD in the first trimester of pregnancy. Our aim is to present abnormal image patterns that are seen in the four-chamber, three-vessel, and trachea views of the fetal heart in the first trimester and to describe their association with specific CHD types. We used a total of 29 cases of CHD from the archives of Filantropia Hospital and the Maternal and Child Health Institute (INSMC) fetal medicine units. We selected cases with a clear and well-documented diagnosis of the CHD type. We identified a series of repeating color doppler flow patterns seen in the four-chamber, three-vessel, and trachea views of the studied cases. Our observations could be developed into a diagnosis algorithm to orientate the examiner to the most likely type of CHD in individual cases.

Endocrinal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

2008 ◽  
Vol 18 (S2) ◽  
pp. 256-264 ◽  
Author(s):  
Heather Dickerson ◽  
David S. Cooper ◽  
Paul A. Checchia ◽  
David P. Nelson
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Healthcare Intervention ◽  
Time Interval ◽  
Quality Reporting ◽  
Cardiac Malformations ◽  
Comprehensive List ◽  
Congenital Cardiac Disease

AbstractA complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the endocrine system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of endocrinal complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.

The impact of actual and perceived disease severity on pre-operative psychological well-being and illness behaviour in adult congenital heart disease patients

2013 ◽  
Vol 24 (2) ◽  
pp. 275-282 ◽  
Author(s):  
Edward Callus ◽  
Elisabeth M. W. J. Utens ◽  
Emilia Quadri ◽  
Cristian Ricci ◽  
Mario Carminati ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Disease Severity ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Well Being ◽  
Illness Behavior ◽  
Psychological State ◽  
Illness Behaviour ◽  
Psychological Well Being

AbstractObjectives: The purpose of this study was to investigate whether the objective medical parameters related to congenital heart disease and patients’ ratings of cardiac disease severity were related to psychological well-being and illness behaviour during the pre-operative period.Methods: A total of 143 patients (63 male patients; 16–73 years old) with congenital heart disease evaluated the severity of their cardiac condition using a numerical rating scale ranging from 0, indicating the least severe condition, to 100, indicating the most severe condition. Psychological well-being was assessed using the Psychological General Well-Being Index (total score ≤60 indicating severe distress) and illness behaviour using the Illness Behavior Questionnaire.Results: Pre-operative psychological well-being was not related to the objective medical parameters reflecting cardiac disease severity. In contrast, total psychological well-being scores correlated significantly with patients’ subjective ratings of disease severity (p < 0.001). When compared with the reference values from the Italian population, the mean scores of the patients on psychological well-being were similar. As regards the Illness Behavior Questionnaire, the scores on denial were higher and those on hypochondria were lower compared with other hospitalised patients.Conclusions: This study shows that the perception of cardiac disease severity, and not the medical parameters in congenital heart disease, is related to the patients’ pre-operative psychological state. Thus, more importance needs to be given to assessing the patients’ pre-operative perception and psychological state independently of cardiac severity. Targeted interventions with regard to the cardiac condition are recommended.

Generalized Bone Changes and Thrombocytopenic Purpura in Association with Intrauterine Rubella

PEDIATRICS ◽  
1965 ◽  
Vol 36 (2) ◽  
pp. 264-268
Author(s):  
AARON R. RAUSEN ◽  
ROBERT D. LONDON ◽  
ABRAHAM MIZRAHI ◽  
LOUIS Z. COOPER
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Rubella Virus ◽  
Congenital Heart ◽  
Newborn Infants ◽  
First Trimester ◽  
Long Bones ◽  
Thrombocytopenic Purpura ◽  
Bone Changes ◽  
First Trimester Of Pregnancy

Two newborn infants are presented whose mothers had rubella in the first trimester of pregnancy. Both infants were born with thrombocytopenic purpura and suggestive evidence of a hemolytic disorder. The second infant had congenital heart disease as well. Roentgenographic changes in the metaphyseal ends of several long bones, observed in the first infant at 3 days of age, regressed completely by 2 months of age. The second infant had roentgenographic evidence of metaphyseal changes of a lesser degree, limited to the distal ends of the femora. These changes were no longer present at 6 weeks of age. Both infants were shown to be harboring an interfering agent with the characteristics of the rubella virus.

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 ◽  
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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