Review Paper. Transplacental Digoxin Treatment In Prenatal Cardiac Problems In Singleton Pregnancies - Meta Analysis (Based On Literature: 1992–2015)

Strzelecka, Iwona; Respondek-Liberska, Maria; Słodki, Maciej; Zych-Krekora, Katarzyna; Cuneo, Bettina F.

doi:10.1515/pcard-2016-0009

Cited by 9 publications

(7 citation statements)

References 38 publications

(31 reference statements)

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“…Although fetal cardiac symptoms are usually bad indicators for prognosis, we report for the first time the value of transplacental digoxin treatment in these cases as early as possible and for as long as possible. Digoxin is usually well accepted by pregnant woman; it was proven in several other fetal cardiac conditions [14]. In this series of cases with AVGM an improvement in CVPS was seen in two survivors and no improvement was observed in non-survivors (Table 2).…”

Section: Discussionmentioning

confidence: 56%

Prognosis for newborns with vein of Galen malformation diagnosed prenatally based on a new scale

Respondek-Liberska¹,

Słodki²

2019

pcard

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Introduction: Vein of Galen malformation occurs rarely and accounts for 1% of intracranial vascular abnormalities, and they usually have poor outcome. Therefore, we focused on the prenatal features that might suggest favourable prognosis. Material and methods: We analysed fetal echocardiograms and neonatal management from 10 fetuses with diagnosis of vein Galen malformations. Results: The size of Galen malformation was mean 35 mm ×19 mm. Five fetuses had transplacental digoxin treatment. Cardiovascular profile score (CVPS) at the initial evaluation was mean 6 ±2, the minimum value was 4, and the maximum value was 10. Cardiovascular profile score at the last evaluation was mean 7.3 ±2.4, but an increase was seen only in two survivors (the third survivor had only one echo examination and did not undergo transplacental treatment). There were two intrauterine demises and eight pregnancies with live born newborns. Mean gestational time of delivery for live born newborns was in the 37 th week. There were four neonatal deaths on days 1, 2, and 3 before attempted neurosurgery. Three newborns had neurosurgery procedures on day 3 (two newborns) and on day 7 (one newborn). The last one died on day 27. Based on our prenatal data we suggested a new scale to predict a prognosis for newborns with vein of Galen malformation. Conclusions: Prenatal detection of Galen aneurysm, CVPS of seven or more before birth, transfer in utero, delivery at term, and earliest possible neurosurgical treatment might be beneficial and change the poor natural outcome known from the past in these cases. Good cooperation between members of the perinatology team might be crucial for saving lives in prenatally diagnosed AVGM.

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Section: Discussionmentioning

confidence: 56%

Prognosis for newborns with vein of Galen malformation diagnosed prenatally based on a new scale

Respondek-Liberska¹,

Słodki²

2019

pcard

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“…FHR measurement is important for preparing an accurate prenatal medical ultrasound report. Although our fetal cardiology referral center deals with various types of fetal arrhythmia and their pharmacological treatment, FHR measurement was absent from more than 50% of cases present in the database [23][24][25]. Our findings demonstrate the need to improve this approach; for example, patients with FHR just below the bottom 5th percentile should be candidates for further cardiological work-up, e.g electrocardiogram with the QTc evaluation.…”

Section: Discussionmentioning

confidence: 81%

Normal ranges of fetal heart rate values for healthy fetuses in Poland, as determined by ultrasound between weeks 18 and 29 of gestation

Sylwestrzak¹,

Nowakowska²,

Murlewska³

et al. 2021

Kardiol Pol

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Background: Fetal heart rate (FHR) is commonly used to assess fetal well-being. Aims:The aim was to establish normal ranges of FHR during pregnancy by umbilical artery (UMB-A) Doppler analysis in a healthy Polish population. Methods:The study was conducted in a tertiary center for fetal cardiology. Data on gestational age (GA), FHR measured on UMB-A, cardiac problems, and extracardiac problems were collected. All fetuses underwent echocardiographic examination. The inclusion criteria comprised normal fetal biometry and biophysical profile, labels of "normal heart anatomy and normal heart function", "no extracardiac malformations", and no "extracardiac anomalies".Results: Based on the data from 258 healthy fetuses, a scatter graph with regression line giving a prognosis of normal values for FHR during pregnancy was prepared (95% confidence interval). The regression equation for FHR, as function of GA in weeks, was found to be: FHR (beats/minute) = 149 -GA according to biometry (weeks) × 0.22; (r = -0.1032; P = 0.098); FHR (beats/ /minute) = 148 -GA according to the last menstrual period (weeks) × 0.16; (r = -0.0722; P = 0.253). The 5 th , 50 th , 95 th percentiles, mean and standard deviation of FHR between weeks 18 and 29 of gestation were calculated. Conclusions:We present the normal ranges for FHR measured on UMB-A for weeks 18 to 29 of gestation in healthy fetuses with normal heart function and anatomy. The obtained values may be of value to departments of obstetrics and should be considered important elements of the basic fetal ultrasound report.

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“…Our patients received postoperatively relatively high doses of digoxin, which could raise safety-related concern. The chosen dosing was based on the literature review [ 27 , 44 , 45 ] and it has its background on given in the literature rate of the drug passing through the placenta to the fetus (feto-maternal ratio). Our results in this field will be addressed in another paper [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Fetal Cardiac Interventions—Are They Safe for the Mothers?

Rebizant

Koleśnik

Grzyb

et al. 2021

JCM

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The aim of fetal cardiac interventions (FCI), as other prenatal therapeutic procedures, is to bring benefit to the fetus. However, the safety of the mother is of utmost importance. The objective of our study was to evaluate the impact of FCI on maternal condition, course of pregnancy, and delivery. 113 mothers underwent intrauterine treatment of their fetuses with critical heart defects. 128 percutaneous ultrasound-guided FCI were performed and analyzed. The patients were divided into four groups according to the type of FCI: balloon aortic valvuloplasty (fBAV), balloon pulmonary valvuloplasty (fBPV), interatrial stent placement (IAS), and balloon atrioseptoplasty (BAS). Various factors: maternal parameters, perioperative data, and pregnancy complications, were analyzed. There was only one major complication—procedure-related placental abruption (without need for blood products transfusion). There were no cases of: procedure-related preterm prelabor rupture of membranes (pPROM), chorioamnionitis, wound infection, and anesthesia associated complications. Tocolysis was only necessary only in two cases, and it was effective in both. None of the patients required intensive care unit intensive care unit admission. The procedure was effective in treating polyhydramnios associated with fetal heart failure in six out of nine cases. Deliveries occurred at term in 89%, 54% were vaginal. The results showed that FCI had a negligible impact on a further course of pregnancy and delivery.

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Review Paper. Transplacental Digoxin Treatment In Prenatal Cardiac Problems In Singleton Pregnancies - Meta Analysis (Based On Literature: 1992–2015)

Cited by 9 publications

References 38 publications

Prognosis for newborns with vein of Galen malformation diagnosed prenatally based on a new scale

Prognosis for newborns with vein of Galen malformation diagnosed prenatally based on a new scale

Normal ranges of fetal heart rate values for healthy fetuses in Poland, as determined by ultrasound between weeks 18 and 29 of gestation

Fetal Cardiac Interventions—Are They Safe for the Mothers?

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