Maternal psychological impact of fetal echocardiography

Sklansky, Mark; Tang, Alvin M. C.; Levy, Denis; Grossfeld, Paul; Kashani, Iraj A.; Shaughnessy, Robin; Rothman, Abraham

doi:10.1067/mje.2002.116310

Cited by 72 publications

(40 citation statements)

References 22 publications

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“…Our finding of high prevalence of pregnants who had fetusus with CHD in their previous pregnancies shows women who are faced with this disease with high mortality and morbidity prefer to learn 'good or bad' result when they offered good counseling. Also, our finding supports studies that suggest increased sensitivity of mothers about FE (13).…”

Section: Discussionsupporting

confidence: 81%

The results of fetal echocardiography in a tertiary center and comparison of low- and high-risk pregnancies for fetal congenital heart defects

Özkutlu¹,

Akça²,

Kafalı³

et al. 2010

Anadolu Kardiyol Derg

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Objective: Fetal echocardiography (FE) is considered for fetal, maternal or hereditary reasons in pregnants with suspect of intrauterine heart disease (IUHD). However, in few studies it was reported that most of the fetuses with IUHD are in the low-risk group (suspicion of IUHD during 2 nd trimester ultrasound, lack of good vision of the heart, self-referral). Our aim is to examine retrospectively the reasons for referral of pregnants, the results of FE, distribution of pregnants having fetuses with IUHD according to low-and high-risk factors and to evaluate reliability of FE. Methods: Our study group consisted of 1395 fetuses and 1370 pregnants underwent FE between 1999 and 2006. These cases included selfreferred women and the pregnants having previous child or family history of cardiac anomaly or referred by obstetricians. The prevalence of IUHDs in low-and high-risk pregnancies was compared by Chi-Square test. Results: The low risk group included 453 patients and the remaining 917 women were in the high-risk group. Intrauterine heart diseases were detected in 152 (10.9%) of 1395 fetuses. The prevalence of IUHDs was 19% in the low-risk group and 7% in the high-risk group. Of the152 fetuses 56.6% were in the low-risk group and 43.4% were in the high-risk group. The sensitivity of FE for diagnose of IUHDs was 97%, the specificity was 100%. Conclusion: Fetal echocardiography is highly reliable method for diagnosing of IUHDs. The most IUHDs occur in the low-risk group. (Anadolu Kardiyol Derg 2010; 10: 263-9) Key words: Fetal echocardiography, congenital heart disease, indication, low-risk and high-risk factors ÖZET Amaç: Fetal, maternal ve herediter nedenlerle FE yapılan gebeler, konjenital kalp hastalıklı (KKH) fetusa sahip olma olasılığı yüksek olan gebelerdir. Ancak yapılan çok az sayıdaki çalışmada KKH'lı fetusların çoğunun düşük riskli (ikinci trimester ultrasonunda KKH şüphesi, kalbin iyi görüntülene-memesi, gebelerin kendi istediğiyle başvurması) gebelik grubuna dahil olduğu bildirilmiştir. Bu çalışmada bölümümüzde son yıllarda FE'si yapılan gebelerin başvuru nedenlerini, ekokardiyografi sonuçlarını ve fetuslarında KKH'ı olan gebelerin düşük ve yüksek risk faktörlerine göre dağılımlarını ve FE sonuçlarımızın güvenilirliğini retrospektif olarak değerlendirdik. Yöntemler: Çalışmamızda Ekim 1999-Haziran 2006 tarihleri arasında Ünitemizde 1536 gebeye FE yapıldı. Postnatal ekokardiyografi sonucu bilinen 1243 normal kalp bulguları olan fetus ile postnatal ekokardiyografisi ve/veya otopsisi bilinen 152 intrauterin kalp hastalıklı (IUKH) fetus olmak üzere toplam 1395 fetus ve 1370 gebe çalışma grubumuzu oluşturdu. Bu olgular, kadın hastalıkları ve doğum uzmanları tarafından yönlendirilen, kendi isteğiyle başvuran ve ailesinde veya daha önceki gebeliklerinde KKH'ğı olan gebelerden oluşmaktadır. Düşük ve yüksek riskli gebelerdeki IUKH'ğı prevalansı Ki-Kare testiyle karşılaştırılmıştır. Bulgular: Düşük risk grubunda 453 (%33.1), yüksek risk grubunda 917 (%66.9) gebe yer almaktaydı. 1395 fetusun 152'sinde (%10.9) IUKH ...

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Section: Discussionsupporting

confidence: 81%

The results of fetal echocardiography in a tertiary center and comparison of low- and high-risk pregnancies for fetal congenital heart defects

Özkutlu¹,

Akça²,

Kafalı³

et al. 2010

Anadolu Kardiyol Derg

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“…418 Detection of CHD further increases maternal anxiety and creates unhappiness during pregnancy. 419 Difficulty in coping, psychological dysfunction, and distress are increased in parents given a prenatal diagnosis of CHD compared with a postnatal diagnosis, and such differences may persist even months after birth. [420][421][422] Identification of potential modifiable variables of maternal stress during pregnancy in which there is prenatal diagnosis of CHD may alter the burden of stress and is worthy of investigation.…”

Section: Maternal and Paternal Effectsmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

973

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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“…3,17 In a study of mothers who had recently delivered infants with congenital heart disease, 92% who had undergone fetal echocardiography reported that they were glad they had the test, and all of the mothers who had not had a fetal echocardiography reported that they wished that they had. 18 Another study found that all parents who had experienced an abnormal fetal echocardiography were glad they had the information so that they could plan for the future. 11 The goal of the present pilot study was to prospectively evaluate (at different time points) coping and psychological functioning of parents of children prenatally diagnosed with congenital heart disease and parents of infants with similar forms of heart disease diagnosed at the time of birth.…”

Section: Introductionmentioning

confidence: 99%

Psychological distress in parents of children with severe congenital heart disease: the impact of prenatal versus postnatal diagnosis

et al. 2007

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Objective: The purpose of the study was to evaluate coping and psychological functioning of parents of children prenatally or postnatally diagnosed with congenital heart disease.Study Design: Parents of 10 infants prenatally diagnosed by fetal echocardiogram and 7 infants postnatally diagnosed with severe congenital heart disease completed the Brief Symptom Inventory (BSI) at the time of diagnosis, at the time of birth and 6 months after birth. Prenatal and postnatal groups were compared to each other and to BSI norms.Result: Although both groups scored higher than test norms at the time of diagnosis, they did not differ significantly from each other. Six months after birth, the postnatal group scores did not differ from test norms, but the prenatal group scores were still significantly higher than test norms. The severity of the child's heart lesion at diagnosis was related to parental distress levels; parents with children with more severe lesions had higher BSI scores. Conclusion:Results suggest the need to provide parents with psychological support, regardless of the timing of diagnosis. Parents of children with more severe lesions may be at risk for higher levels of psychological distress, particularly over time.

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Maternal psychological impact of fetal echocardiography

Cited by 72 publications

References 22 publications

The results of fetal echocardiography in a tertiary center and comparison of low- and high-risk pregnancies for fetal congenital heart defects

The results of fetal echocardiography in a tertiary center and comparison of low- and high-risk pregnancies for fetal congenital heart defects

Diagnosis and Treatment of Fetal Cardiac Disease

Psychological distress in parents of children with severe congenital heart disease: the impact of prenatal versus postnatal diagnosis

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