Pregnancy follow-up and outcomes of patients diagnosed with fetal hypoplastic left heart syndrome

Abstract

Objective: The study aimed to evaluate the follow-up and outcomes of patients diagnosed with fetal hypoplastic left heart syndrome in the prenatal period.
 Materials: Between January 2017 and June 2019 the data of 36 patients diagnosed with fetal hypoplastic left heart syndrome (HLHS) in Etlik Zübeyde Hanım Woman’s Health Care Training and Research Hospital (EZH) were evaluated retrospectively. All patients who suspected for any fetal or cardiac anomaly were evaluated in detail ultrasound by two senior perinatologists and a pediatric cardiologist fort a detailed cardiac evaluation. The demographic characteristics, pregnancy follow-up and maternal and fetal outcomes of patients were evaluated.
 Results: During the study period fetal echocardiography was performed for 10.377 patients. A totally 382 (3.7%) fetuses were diagnosed with congenital heart diseases and 36 (9.4%) of these fetuses were diagnosed with hypoplastic left heart syndrome. Additional extracardiac anomalies were detected in 13 (36.1%) fetuses. Concomitant fetal cardiac anomalies were detected in 15 patients and ventricular septal defect (n: 11) and double outlet right ventricle (n:8) were the most common concomitant cardiac anomalies. Eight pregnancies with fetal HLHS were terminated. The data of 10 patient’s newborns were obtained and none of them lived up to a year.
 Conclusion: The study revealed that the majority of patients with fetal HLHS are in low-risk population thus the routine fetal cardiac evaluation is of great importance. The prognosis and outcome of the pregnancy diagnosed with fetal HLHS are poor. The option of termination of the pregnancy should be considered.