Recommendations for the practice of fetal cardiology in Europe

Allan, Lindsey A.; Dangel, Joanna; Fesslová, Vlasta; Marek, Jan; Mellander, Mats; Oberhänsli, I; Oberhoffer, Renate; Sharland, Gurleen; Simpson, John; Sonesson, Sven Erik

doi:10.1017/s1047951104001234

Cited by 66 publications

(59 citation statements)

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“…The high-risk group comprised pregnant women referred for reasons known to be indications for FE (5). Low-risk group included pregnant women referred by an obstetrician for reasons other than indications of FE (5) or presented on their own will for screening with no obvious high-risk.…”

Section: Study Populationmentioning

confidence: 99%

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Prevalence and distribution of structural heart diseases in high and low risk pregnancies

Özbarlas¹,

Erdem²,

Küçükosmanoğlu³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Doğuştan kalp hastalıkları için yüksek ve düşük risk taşıyan gebelerde intrauterin kalp hastalığı sıklığını belirlemek ve karşılaştırmak. Yöntemler: Üniversitemiz Tıp Fakültesi Pediatrik Kardiyoloji Ünitesinde fetal ekokardiyografi yapılan 3782 gebenin kayıtları ve ekokardiyografi sonuçları retrospektif olarak değerlendirildi. Gruplar arasındaki değişkenler Ki-kare testi kullanılarak analiz edildi. Bulgular: Yüksek ve düşük riskli gruplardaki tüm fetüslerin 213'ünde (%5.6) yapısal kalp hastalığı bulundu. En sık patolojiler ventriküler septal defekt (%36.2) ve atriyoventriküler septal defekt (%14.1) idi. Yüksek riskli grupta doğuştan kalp hastalığı sıklığı %7.8 (169 fetüs) bulundu; %4.1'i kompleks, %2.3'ü önemli, %1.4'ü minör patolojiydi. Düşük riskli grupta bu oran %2.7 (44 fetüs) idi; %0.6'sı kompleks, %0.8'i önemli ve %1.3'ü minör patolojiydi. Bu grupta bazı nedenlerle başvuranlarda yapısal kalp hastalığı sıklığı yüksek bulundu; önceki gebelikte intrauterin fetal ölüm (%6.3), anormal birinci ve ikinci üç aylık dönem tarama testleri (%4.3) ve çoğul gebelik (%3.4). Fetal ekokardiyografik incelemenin duyarlılığı %86, özgül-lüğü %98 bulundu. Sonuç: Doğuştan kalp hastalığı sıklığı beklenildiği gibi yüksek riskli grupta daha yüksek bulundu. Düşük riskli grupta yer almalarına rağmen önceki gebelikte intrauterin fetal ölüm, anormal birinci ve ikinci üç aylık dönem tarama testleri ve çoğul gebelik nedeniyle başvuranlardaki kalp hastalığı sıklığı ile yüksek riskli gruptaki kalp hastalığı sıklığı arasında istatistiksel olarak anlamlı bir fark bulunmadı. Bu nedenle kardiyoloji kliniğinin bu konuda uzman kardiyoloğu ve ekipmanı yeterli ise yukarıdaki nedenlerle başvuran gebelere rutin fetal ekokardiyografik çalışma yapılmasını öneriyoruz. (Anadolu Kardiyol Derg 2011; 2: 125-30) Anahtar kelimeler: Doğuştan kalp hastalığı, fetal ekokardiyografi, yüksek riskli gebelik, düşük riskli gebelik ABSTRACT Objective: To establish and compare the frequency of intrauterine congenital heart defects in high-risk and low-risk pregnancies for congenital heart diseases. Methods: Records of 3782 patients who underwent fetal echocardiography at the Pediatric Cardiology Unit were reviewed for reasons of referral and results of echocardiography retrospectively. The categorical variables between the groups were analyzed using a Chi-square test. Results: Structural heart defects were found in 213 (5.6%) fetuses in both high and low risk groups. Most common defects were ventricular septal defect (36.2%) and atrioventricular septal defect (14.1%). Frequency of congenital heart diseases was 7.8% (169 fetuses) in high-risk group: 4.1% were complex, 2.3% significant and 1.4% were minor. In low-risk group, the frequency was 2.7% (44 fetuses): 0.6% were complex, 0.8% significant and 1.3% were minor. In this group, rates of congenital defects were high regarding particular reasons: intrauterine fetal death in previous pregnancy (6.3%), abnormal first or second trimester screening tests (4.3%), and multiple gestations (3.4%). The sensitivity and...

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Section: Study Populationmentioning

confidence: 99%

“…Complex heart defects or chromosome anomalies associated with heart defects may result in early fetal loss or still birth. Today, FE is recommended to all patients with high-risk pregnancies for fetal CHD (5). The frequency of CHD in low-risk pregnancies and in the screening groups were found to be higher than the live birth rate (6,7).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and distribution of structural heart diseases in high and low risk pregnancies

Özbarlas¹,

Erdem²,

Küçükosmanoğlu³

et al. 2011

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

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“…August 11,2015 methods to evaluate and maintain quality and to establish performance standards. 2 There has also been a recent initiative to develop tools for assessment of quality and accuracy in performing and reporting pediatric echocardiograms.…”

Section: E58 Circulationmentioning

confidence: 99%

“…[8][9][10][11] As with TEE, some trainees may wish to attain a higher level of competency in performing and interpreting fetal echocardiography during core fellowship.…”

Section: Fetal Echocardiographymentioning

confidence: 99%

Task Force 2: Pediatric Cardiology Fellowship Training in Noninvasive Cardiac Imaging

Srivastava¹,

Printz²,

Geva³

et al. 2015

Circulation

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“…The information that is available suggests that, regardless of surgical approach, staged surgical reconstruction or transplantation, long-term functional and cognitive behavior is strongly related to initial condition at diagnosis, and hence is variable [29][30][31]. Prenatal diagnosis, fetal intervention, and its impact on survival after the first stage of palliation, are areas of current study [32][33][34]. The limited information available has suggested that infants diagnosed during the prenatal period are more likely to survive the initial stage of palliation as compared to those that are not diagnosed during the prenatal period [35].…”

Section: Unresolved Questionsmentioning

confidence: 99%

Coarctation of the Aorta

2014

Comprehensive Surgical Management of Congenital Heart Disease

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Hypoplastic left heart syndrome(HLHS) refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other leftsided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch). Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision relative to treatment, and long-term prognosis as information on longterm survival and quality of life for those born with the syndrome is limited. Disease name and synonymsThe congenital heart lesion more commonly known today as hypoplastic left heart syndrome (HLHS) was initially termed hypoplasia of the aortic tract complex by Lev in 1952 [1]. This initial description resulted from examination of a series of specimens found to have isolated hypoplasia of the aorta, hypoplasia of the aorta and ventricular septal defect, and hypoplasia of the aorta with aortic stenosis or atresia, with and without mitral stenosis or atresia. The series of Lev was followed by the study of Noonan and Nadas, who in 1958 first used the term hypoplastic left heart syndrome collectively to describe their series of specimens with multiple malformations involving leftsided structures of the heart [2].

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Recommendations for the practice of fetal cardiology in Europe

Cited by 66 publications

References 0 publications

Prevalence and distribution of structural heart diseases in high and low risk pregnancies

Prevalence and distribution of structural heart diseases in high and low risk pregnancies

Task Force 2: Pediatric Cardiology Fellowship Training in Noninvasive Cardiac Imaging

Coarctation of the Aorta

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