Prenatal grading of fetal congenital heart disease and its influence on decision making during pregnancy and postnatal period: a prospective study

Gowda, Mamatha; Thiagarajan, Monica; Satheesh, S; Mondal, Nivedita; Gochhait, Debasis; Godipelli, Laxmi

doi:10.1080/14767058.2020.1814245

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…The results of this study demonstrated that the ve most common fetal cardiac defects were ventricular septal defect (24.00%), tetralogy of Fallot (13.00%), aortic coarctation (8.5%), atrioventricular septal defect (6.5%), single atrium and single ventricle (5.5%). Suggesting that septal defect and conus arterial malformations were the major types of fetal CHD, which was consistent with prior studies [10][11][12]. We also found that, of all the cases, only 30.50% (122/400) with single cardiac defects belonged to group A, and most cases were in group B, C, and D, with other cardiac defects and extracardiac abnormalities, which was in keeping with previous studies [7,8,11].…”

Section: Discussionsupporting

confidence: 93%

“…We applied the clinical prognosis grading system to evaluate the severity of the dominant cardiac lesions and discovered that most cases belonged to Grade -(9.75% in Grade , 40.75% in Grade , 37.75%in Grade ), which have a good prognosis and recommended retaining, and as the rank increasing, the termination rate in each grade gradually rising. A variety of risk categories and grading systems, including our prognosis grading system, have been proven to be helpful in predicting prognosis and facilitating decision-making of fetal cardiac defects [12,32]. Grade refers to normal variation, Grade defects are expected to have effective postnatal surgical or medical intervention and rare postoperative complications, so strongly recommend retaining, Grade lesions have good postnatal surgical treatment results and rare postoperative serious complications, which is recommended retaining, while Grade defects often require staging surgery and have poor prognosis, and comprehensive consultation is recommended to help parents to reach decisions.…”

Section: Discussionmentioning

confidence: 99%

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A retrospective analysis of fetal heart defects in China: Investigating the influencing factors of pregnancy outcomes and evaluating the value of the multidisciplinary team cooperation approach

Zhe²

2022

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Purpose To explore the impactors of pregnancy outcomes of fetal heart defects and evaluate the influence of a multidisciplinary team cooperation approach. Methods A retrospective study of fetal cardiac defects diagnosed at our institution from January 2012 to June 2021 was carried out. Clinical data, including types of cardiac malformations, accompanying defects, genetic results, and pregnancy outcomes were analyzed. Results Among 400 fetuses, 122 belonged to group A (single heart defect without extracardiac defect), 115 in group B (single heart defect with extracardiac abnormalities), 100 in group C (multiple cardiac defects without extracardiac abnormalities), and 63 belonged to group D (multiple cardiac defects with extracardiac abnormalities). The termination rate in the four groups was 44.26%, 86.09%, 70%, and 82.54%, respectively (P<0.05). Multiple logistics regression analysis revealed that co-existence of extracardiac defects (OR 7.347, CI 3.674,14.694), with pathogenic genetic anomalies (OR 7.493, CI 2.051,27.372), higher prognosis grades (OR 6.307, CI 3.943,10.088) and diagnosed in later gestational age (OR 0.819, CI 0.753, 0.890)were significantly associated with the termination of pregnancy. The MDT group had a significantly lower rate of pregnancy termination, particularly in groups C and D (p<0.001). Conclusion It is important to process comprehensive cardiac and extracardiac ultrasound assessment and further genetic testing of fetal cardiac defects. Diagnosed gestational age, the severity of heart lesions, combined with extracardiac abnormalities, and identified pathogenic genetic abnormalities influence pregnancy outcomes. Multidisciplinary team cooperation is an effective approach and should be applied in fetal cardiac defects management to reduce unnecessary termination of pregnancy.

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