Fetal cardiac tumours in a referral prenatal cardiology centre – series of 37 cases with neonatal follow-up

Abstract

Introduction: Fetal cardiac tumours are relatively rare findings. The aim of this research was to present the natural course in a series of 37 fetuses with cardiac tumours, who had fetal echocardiography performed and the pregnancies had been continued until term. Material and methods: This was a retrospective analysis of 37 cases with prenatally detected heart tumour. The study group was divided into multiple-and single-tumour subgroups and into survivors versus non-survivors. The number of survivors in subgroups and the incidence of prognostic factors were compared by c 2 test. The presence of additional cardiac anomalies, the way of delivery and neonatal follow-up was analysed. The literature (Pub Med) was reviewed. Results: There was no statistical difference between the number of survivors in groups of single versus multiple tumours (p > 0.05). In group of non-survivors there was a higher incidence of bad prognostic factors detected prenatally: pericardial effusion, mitral regurgitation, and cardiomegaly (p < 0.05). The authors suggested a different way of perinatal care and counselling in multiple and single fetal heart tumours. Conclusions: Fetal cardiac tumours in the majority of cases were rhabdomyoma, and in case of normal heart anatomy and normal intracardiac flow the short-term prognosis was good. Fetal single heart tumour with progression of its size in the third trimester may require early surgical resection, so delivery in a tertiary perinatal and cardiac surgery centre might be necessary. Pericardial effusion, mitral regurgitation, and cardiomegaly might implicate a worse prognosis in the case of fetal heart tumour. Fetal cardiac tumour may require a multispecialist team approach to benefit from early detection and diagnosis.