Cardiac tumors are rarely diagnosed in utero. Rhabdomyomas are the most common fetal cardiac tumors. They are usually diagnosed during the first year of life after obstruction of a valve orifice or a cardiac chamber; but they can be detected by echocardiography as early as the second trimester. Rhabdomyomas are usually small. Fetal hydrops and pericardial effusion are rare. The most important indication of tuberous sclerosis in the prenatal period is cardiac rhabdomyoma. Early diagnosis of cardiac rhabdomyoma is thus important for early diagnosis of tuberous sclerosis. This case report concerns the prenatal diagnosis of both multiple fetal cardiac rhabdomyomas and tuberous sclerosis.
Background
To review the obstetric outcomes of pregnancies with anencephalic fetuses when these pregnancies are not terminated and ongoing.
Methods
A retrospective chart review is made of the cases with a prenatal diagnosis of anencephaly and who were opted to continue the pregnancy in 1-year period. The evaluated data included gestational age at diagnosis, gestational age at birth, labor induction rates, cesarean delivery rates, stillbirth, shoulder dystocia rate, antepartum and postpartum hemorrhage.
Results
A total of 28 cases that were selected from 87 cases with the diagnosis of anencephaly are included in the study. The average gestational age at diagnosis was 18 weeks. The average gestational age at birth was 31 weeks (range 23 - 37 weeks). Stillbirths were reported in 32% (9/28). Polyhydramnios developed at six patients and two of them required amniodrainage due to severe polyhydramnios. Vaginal birth was achieved in 67% (19/28) of the patients. Labor induction was applied at total 17 patients and one of them had gone to cesarean section due to failed induction. There were two cases of shoulder dystocia. Nine patients had gone to cesarean delivery. Any other complication was not encountered.
Conclusions
Parents should be counseled in detail about continuation of an anencephalic pregnancy before making their decision. The information about “what an anencephalic pregnancy can lead”' should be given. The redundant cesarean deliveries, polyhydramnios and associated complications, obstetrical hemorrhage risk should be discussed with patients. It should also be emphasized that these maternal risks are for the sake of a non-life expectant baby.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.