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Am J Perinatol 2001; 18(7): 363-372
DOI: 10.1055/s-2001-18696
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Perinatal Management of Fetal Cardiac Anomalies in a Specialized Obstetric-Pediatrics Center

Véronique Mirlesse1 , Adriano Cruz1 , Jérome Le Bidois2 , Patricia Diallo1 , Laurent Fermont2 , François Kieffer3 , Jean François Magny3 , François Jacquemard1 , Ronaldo Levy1 , Marcel Voyer3 , Fernand Daffos1
  • 1Service de Médecine fœtale, Institut de Puériculture, Paris. France
  • 2Centre de cardiologie périnatale, Institut de Puériculture, Paris. France
  • 3Service de Réanimation néonatale, Institut de Puériculture, Paris. France
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Publication History

Publication Date:
03 December 2001 (online)

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ABSTRACT

Perinatal teams dealing with fetal heart disease frequently wonder which pregnancies might be terminated, and when delivery should take place in a specialized surrounding. We present a retrospective study of 229 fetuses, in which prenatal ultrasound showed a cardiac anomaly not compatible with a standard maternity ward delivery. One hundred nineteen pregnancies were terminated (group I) while 110 pregnancies led to the birth of a live baby (group II). Pathology in group I was discovered earlier than in group II (24 vs. 29.3 weeks' gestation; p <0.01), and associated malformations or chromosomal anomalies were much more frequent in group I (80/119 vs. 9/110; p <0.001). Among live born babies, three infants with transposition of the great arteries underwent Rashkind atrioseptostomy in the delivery room. With a minimum follow-up of 12 months, 69 children (63%) have undergone surgery. Among 92 survivors (1 child is lost to follow-up), 78 (71%) are asymptomatic and 14 symptomatic.

Early prenatal diagnosis of fetal heart anomalies significantly facilitates prenatal work-up and perinatal care. We present the types of pathology having led to termination and define the situations in which children are at risk of perinatal hemodynamic compromise.

KEYWORD

Congenital heart disease - prenatal diagnosis - perinatal management

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