Cardiology 2013. Part II.
March 9, 2014
Accession Number: 23474606
Keywords: Arrhythmias, Cardiac/surgery
Cardiotonic Agents/therapeutic use
Endocarditis, Non-Infective/prevention & control
Heart Valve Diseases/diagnosis/etiology/*surgery
*Heart Valve Prosthesis
Heart Valve Prosthesis Implantation/*methods
Rheumatic Fever/prevention & control
Notes: Vahanian, Alec
Antunes, Manuel J
Borger, Michael Andrew
Carrel, Thierry P
De Bonis, Michele
Von Oppell, Ulrich Otto
Zamorano, Jose Luis
G Ital Cardiol (Rome). 2013 Mar;14(3):167-214. doi: 10.1714/1234.13659.
Reference Type: Journal Article
Record Number: 901Author: Vaidyanathan, B., Kumar, S., Sudhakar, A. and Kumar, R. K.
Title: Conotruncal anomalies in the fetus: Referral patterns and pregnancy outcomes in a dedicated fetal cardiology unit in South India
Journal: Ann Pediatr Cardiol
Short Title: Conotruncal anomalies in the fetus: Referral patterns and pregnancy outcomes in a dedicated fetal cardiology unit in South India
Alternate Journal: Annals of pediatric cardiology
ISSN: 0974-2069 (Print)
Accession Number: 23626429
Abstract: OBJECTIVE: To describe the referral patterns and pregnancy outcomes of fetuses with conotruncal anomalies (CTA) from a fetal cardiology unit in South India. METHODS: Records of 68 women identified to have diagnosis of CTA on fetal echocardiography (mean gestational age 26.8 +/- 5.9 weeks; range 17-38 weeks) during the period 2008-2011 were reviewed. RESULTS: The most common indication for referral was suspected congenital heart disease during routine antenatal scan (89.7%). The various CTA diagnosed included Tetralogy of Fallot (TOF, 44.1%), Double outlet right ventricle (DORV, 27.9%), Transposition of great vessels (TGA, 8.8%), TOF with pulmonary atresia (TOF-PA, 8.8%), TOF absent pulmonary valve (TOF-APV, 7.4%) and truncus arteriosus (TA, 2.9%). Extra cardiac anomalies were reported in 4 fetuses (7.1%). Pregnancy outcomes included pregnancies not culminating in live-birth (54.4%), delivery at term (41.2%) with 3 patients (4.4%) being lost to follow-up. Proportion of pregnancies not culminating in live-birth lesion wise include: TOF (53.3%), DORV (52.6%), TGA (50%), TOF -APV (80%), TOF-PA (50%), and TA (50%). Twenty-four babies (35.3%) received post-natal cardiac care with 5 (7.4%) undergoing neonatal surgical procedures. Seven babies (10.3%) died in neonatal period, including 2 who underwent surgery. The accuracy of fetal echo was 96.4% for primary lesion and 67.9% for complete segmental diagnosis. CONCLUSIONS: Pre-natal diagnosis of CTA, despite a high diagnostic accuracy, prompted utilization of post-natal tertiary cardiac care in a limited proportion of patients, including those with reparable lesions. Focus in developing countries should shift towards earlier referral, improving awareness about treatment options and a comprehensive evaluation for associated anomalies.