Fetal cardiac output in the isoimmunized pregnancy: A pulsed Doppler-echocardiographic study of patients undergoing intravascular intrauterine transfusion

Copel, Joshua A.; Grannum, Peter; Green, Jacqueline J.; Belanger, Kathy; Hanna, Nagui; Jaffe, C. Carl; Hobbins, John C.; Kleinman, Charles S.

doi:10.1016/0002-9378(89)90520-6

Cited by 59 publications

(33 citation statements)

References 11 publications

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“…167 Pulsed Doppler assessment of ventricular outflows can be used to calculate ventricular stroke volumes and outputs 214 and may be helpful in pregnancies at risk for high fetal cardiac output, including but not limited to anemias, arteriovenous malformations, acardiac twin gestations, and agenesis of the ductus venosus. 129,179,180 Reversal of flow in diastole in the aortic isthmus may identify the fetus with significant vasodilation of brain vessels or "brain sparing." 211 Pulsed Doppler interrogation of pulmonary venous flow may be used not only to confirm normal and abnormal pulmonary venous connections 215 but also to provide evidence of the severity of left atrial hypertension in fetuses with hypoplastic left heart syndrome (HLHS) and a restrictive or intact atrial septum.…”

Section: Doppler Imagingmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

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990

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Section: Doppler Imagingmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

Self Cite

990

543

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“…Portanto, nestes casos pode não ocorrer elevação nas velocidades de fluxo nos diversos leitos vasculares, incluindo a ACM. Fetos gravemente anêmicos, com concentração de hemoglobina menor que 7 g/dL, podem não exibir um estado hiperdinâmico de fluxo, justificando, desta forma, a diferença em nossos resultados 20,21 . No grupo estudado, dos 83 casos previamente selecionados, 50 apresentavam hemoglobina fetal maior ou igual a 10 g/dL.…”

Section: Discussionunclassified

Diagnóstico não invasivo da anemia fetal pela medida do pico de velocidade sistólica na dopplervelocimetria da artéria cerebral média

Taveira¹,

Cabral²,

Leite³

et al. 2004

Rev. Bras. Ginecol. Obstet.

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IntroduçãoO progressivo desenvolvimento da propedêu-tica obstétrica tem propiciado o surgimento de téc-nicas não invasivas para avaliação das condições fetais. Uma situação clínica em que se busque melhor aplicação dos métodos não invasivos é quando há risco para anemia fetal. Isso pode significar redução acentuada no número de procedimentos invasivos, reservando-os apenas para os casos mais graves, nos quais há indicação para tratamento intra-uterino.Em nosso meio, a isoimunização materna pelo fator Rh é a causa mais freqüente de hemólise fetal. O diagnóstico do grau de anemia fetal pode ser determinado por meio da amniocentese, quando se realiza a espectrofotometria do líquido amniótico, ou pela dosagem da hemoglobina no sangue obtido por cordocentese. Os métodos invasivos citados apresentam riscos para gestante e para o feto, além de que devem ser repetidos com alguma freqüência para o acompanhamento dos valores da hemoglobina fetal, no evolver da gestação 1,2 . Dos métodos não invasivos estudados para

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“…In association with low pulsatility index of the artery and hypervascularity in the tumor, this hypercardiac perfor- mance may be attributed to arteriovenous shunting effect of the tumor. A low hemoglobin concentration observed at birth might be another factor that exerted significant influence on fetal cardiac function [8]. Considering anemia at birth and prenatal MRI findings ( fig.…”

Section: Discussionmentioning

confidence: 99%

Fetal Glioblastoma: Rapid Growth during the Third Trimester

Kamitomo

Sameshima²,

Uetsuhara³

et al. 1998

Fetal Diagn Ther

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We present a case of fetal glioblastoma which appeared after 28 weeks’ gestation. The first ultrasonographic finding was an enlarged fetal head with right shifted falx cerebri at 31 weeks’ gestation. At 33 weeks, a large and high echogenic mass in the left hemisphere and right enlarged ventricle was identified. Magnetic resonance imaging showed that the tumor was localized in the left hemisphere and a margin of the tumor was defined. Because fetal well-being judging from biophysical parameters was good and we considered that the tumor was resectable, a male fetus weighing 2,670 g was delivered at 34 weeks’ gestation by cesarean section. However, he was inoperable due to consumptive coagulopathy and rapid growth of the tumor, and died on the 41st day of life.

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Fetal cardiac output in the isoimmunized pregnancy: A pulsed Doppler-echocardiographic study of patients undergoing intravascular intrauterine transfusion

Cited by 59 publications

References 11 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnóstico não invasivo da anemia fetal pela medida do pico de velocidade sistólica na dopplervelocimetria da artéria cerebral média

Fetal Glioblastoma: Rapid Growth during the Third Trimester

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