Isolated pericardial effusion: an indication for fetal karyotyping?

Sharland, GK; Lockhart, Susan M.

doi:10.1046/j.1469-0705.1995.06010029.x

Cited by 37 publications

(29 citation statements)

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“…Other cardiac markers of DS described in the literature are intracardiac foci (incidence in DS 18%) [24] and isolated pericardial effusion (26%) [25], but in our cases in late pregnancy these were relatively rare.…”

Section: Discussionmentioning

confidence: 45%

Can We Suspect Fetal Down Syndrome by Heart Evaluation during the Second Half of Pregnancy?

Respondek‐Liberska

Nowicki²,

Krasoń³

et al. 1999

Fetal Diagn Ther

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Thirty fetuses with Down syndrome, who had detailed fetal echocardiography and sonography at the tertiary center with videotape recordings, were retrospective analyzed by one observer with a specially prepared flow sheet. The mean gestational age of the fetuses at the time of the study was 31 ± 5.6 (minimum 21, maximum 39) weeks. The ‘main’ fetal abnormalities were congenital heart defect (CHD): in 13 cases (43.3%) an abnormal 4-chamber view was recorded, including 6 cases (20%) of isolated CHD and 7 (23.3%) of coexisting CHD + extracardiac malformation. Of the 13 cases of CHD, there were 12 cases of atrio-ventricular canal and 1 case of ventricular septal defect. Normal heart anatomy was recorded in 17 cases (56.7%), including 2 with tricuspid value regurgitation. From the videotape recordings also some ‘minor’ abnormalities were noticed in a few cases such as: femur length shortening; sandal gap; pericardial effusion; macroglossia; echogenic bowel; absent diastolic flow in the umbilical artery, and others. The prevalence of CHD in the study group was similar to the prevalence of CHD in the comparison group of 20 newborns with Down syndrome, born during the same period of time at the same institution, who had not had prenatal scanning at all (χ², p > 0.05). Conclusions: (1) the main ‘major’ abnormality which might be detected in a fetus with Down syndrome after 20 weeks of pregnancy is CHD, which was presented in 43.3% of this series; (2) the presence of any extracardiac malformation should prompt the sonographer for detailed heart evaluation, and (3) fetal echocardiography may increase the accuracy of ‘genetic sonogram’ in Down syndrome.

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Section: Discussionmentioning

confidence: 45%

Can We Suspect Fetal Down Syndrome by Heart Evaluation during the Second Half of Pregnancy?

Respondek‐Liberska

Nowicki²,

Krasoń³

et al. 1999

Fetal Diagn Ther

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“…In cases of isolated PE, chromosomal anomalies (31%), especially trisomy 21 (26%), are reported to have a high prevalence [4]. In many cases of Down syndrome associated with PE, there is also a high prevalence of hypothyroidism and myelopoiesis [11,12,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…All newborns were healthy, and 11 of the 24 (45.8%) cases of PE resolved spontaneously. There was no correlation between the size of the PEs and the regression of pericardial fluid, adverse outcomes, or mortality rate [1,2,4]. However, several postnatal abnormalities were observed in 4 cases of persistent PE until the final echocardiogram before delivery.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, 506 routine ultrasonographic scans showed a 2% PE rate [3]. Although isolated PE occurs transiently and has good prognosis, there is an increase in the incidence of chromosomal abnormalities, especially trisomy 21 [4]. However, there are few studies in the literature on the correlation between isolated PE and chromosomal abnormalities.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Prenatally Diagnosed Cases of Isolated and Nonisolated Pericardial Effusion

Kyeong

Won²,

Lee³

et al. 2014

Fetal Diagn Ther

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Objective: The purpose of this study was to investigate the clinical outcome of fetal pericardial effusion (PE). Methods: This study involved a retrospective review of prenatally diagnosed PE cases. The criterion for inclusion was pericardial fluid in an area greater than 2 mm in diameter. Results: A total of 276 cases of PE and 252 cases diagnosed with other anomalies were initially reviewed. PE is associated with cardiac malformation, hydrops fetalis, extracardiac abnormalities, infections, anemias, intrauterine growth restriction, and aneuploidy markers in fetuses. Of these reviewed cases, 24 cases of isolated fetal PE were studied. In all cases, pericardial fluid filled an area ranging from 2 to 17 mm in diameter. Four cases of isolated PE had an abnormal postnatal condition, and 3 cases were excluded due to lack of follow-up. The size of the PE was not related to the regression of pericardial fluid, adverse outcomes or mortality rate associated with the isolated PE. All newborns were healthy, and there were no chromosomal abnormalities in the study population. Conclusions: There were no adverse clinical outcomes or chromosomal abnormalities in the fetuses diagnosed with isolated PE. Most cases of isolated PE resolved spontaneously and were associated with a good prognosis.

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“…There is a high incidence between foetal isolated pericardial effusion and trisomy 21. 7,8 It has been observed that massive pericardial effusion (PE) in hypothyroid children with Down syndrome completely resolved with medical treatment without pericardiocentesis. 5,9 This was accomplished in our case; serial echocardiographic examinations documented the decrease in PE.…”

Section: Discussionmentioning

confidence: 99%

Down syndrome associated with hypothyroidism and chronic pericardial effusion: echocardiographic follow-up

Said

Droste²,

Derks³

et al. 2007

NHJL

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We present a 39-year-old male patient with Down syndrome who was evaluated for fatigue, palpitations and bouts of cyanosis. Physical examination showed features of trisomy-21(Down syndrome), with a slow pulse rate, distant cardiac sounds and absent apex beat. He had normal jugular venous pressure without pulsus paradoxus. The ECG showed QRS microvoltage and flattened P and T segments. The 48-hour ambulatory ECG depicted normal sinus rhythm with intermittent short PR interval without tachyarrhythmias. The chest Xray revealed cardiomegaly without pulmonary venous congestion. Although serial transthoracic echocardiographic examination demonstrated pericardial effusion with features of tamponade, there were no overt signs of clinical cardiac tamponade. Biochemically, the serum thyroxine of 3 pmol/l (normal 10 to 25) and thyroid-stimulating hormone of 160 mU/l (normal 0.20 to 4.20)) were compatible with hypothyroidism. The patient was treated with L-thyroxine sodium daily, which was gradually increased to 0.125 mg daily. Within a few months he lost weight and became more alert; furthermore, the symptoms of hypothyroidism and the pericardial effusion resolved. It can be concluded that Down syndrome may be associated with hypothyroidism and pericardial effusion. These were alleviated following hormone replacement. Regular evaluation of thyroid function tests is important in Down syndrome. (Neth Heart J 2007;15:67-70.).

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Isolated pericardial effusion: an indication for fetal karyotyping?

Cited by 37 publications

References 0 publications

Can We Suspect Fetal Down Syndrome by Heart Evaluation during the Second Half of Pregnancy?

Can We Suspect Fetal Down Syndrome by Heart Evaluation during the Second Half of Pregnancy?

Clinical Outcomes of Prenatally Diagnosed Cases of Isolated and Nonisolated Pericardial Effusion

Down syndrome associated with hypothyroidism and chronic pericardial effusion: echocardiographic follow-up

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