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Prenatal cardiology


Authors: Tomek Viktor
Authors‘ workplace: Dětské kardiocentrum, 2. lékařská fakulta, Univerzita Karlova a FN v Motole, Praha
Published in: Čes-slov Pediat 2024; 79 (1): 9-16.
Category:
doi: https://doi.org/10.55095/CSPediatrie2024/001

Overview

Prenatal cardiology is a subspecialty of pediatric cardiology focused mainly on the diagnosis and treatment of heart lesions, predominantly congenital heart defects. A nationwide prenatal detection of major congenital heart defects in the Czech Republic exceeded 80 % in the current era. Termination of pregnancy of major heart defects has decreased from 70 % in 1991 to 43 % in 2023 but remains high in fetuses with univentricular heart and those major heart defects with associated comorbidities. The introduction of first trimester screening resulted in higher termination rate at early stage but did not revert the overall decreasing trend in termination of pregnancy. In cardiac abnormalities with favorable outcome, the termination rate decreased significantly, becoming rather exceptional in recent years. This review focuses on advances in prenatal detection of heart anomalies and treatment of arrhythmias and some specific heart defects that are increasingly used in clinical practice.


Sources

1.     Samánek M, Vorísková M. Congenital heart disease among 815,569 children born between 1980 and 1990 and their 15-year survival: a prospective Bohemia survival study. Pediatr Cardiol 1999; 20: 411–417.

2.     van der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011; 58(21): 2241–7. 

3.     Donofrio MT, Moon-Grady AJ, Hornberger LK, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014; 129: 2183–2242. 

4.     Tomek V, Jičínská H, Klásková E, et al. Odborné stanovisko k organizaci prenatální kardiologie v České republice. Vypracované Pracovní skupinou dětské kardiologie České kardiologické společnosti. Cor Vasa 2020; 62: 60–62.

5.     Moon-Grady, Anita J, et al. Guidelines and recommendations for performance of the fetal echocardiogram: an update from the American Society of Echocardiography. J Am Soc Echocardiogr 2023; 36(7): 769–723.

6.     International Society of Ultrasound in Obstetrics and Gynecology; Carvalho JS, Allan LD, Chaoui R, et al. ISUOG Practice Guidelines (updated): sonographic screening examination of the fetal heart. Ultrasound Obstet Gynecol 2013; 41: 348–359. 

7.     Jørgensen DE, Vejlstrup N, Jørgensen C, et al. Prenatal detection of congenital heart disease in a low risk population undergoing first and second trimester screening. Prenat Diagn 2015; 35(4): 325–330. 

8.     Lytzen R, Vejlstrup N, Bjerre J, et al. Live-born major congenital heart disease in Denmark: incidence, detection rate, and termination of pregnancy rate from 1996 to 2013. JAMA Cardiol 2018; 3(9): 829–837. 

9.     Tomek V, Jičínská H, Pavlíček J, et al. Pregnancy termination and postnatal major congenital heart defect prevalence after introduction of prenatal cardiac screening. JAMA Netw Open 2023; 6(9): e2334069. 

10.     Quartermain MD, Hill KD, Goldberg DJ, et al. Prenatal diagnosis influences preoperative status in neonates with congenital heart disease: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Pediatr Cardiol 2019; 40(3): 489–496. 

11.     Rempel GR, Cender LM, Lynam MJ, et al. Parents’ perspectives on decision making after antenatal diagnosis of congenital heart disease. J Obstet Gynecol Neonatal Nurs 2004; 33(1): 64–70. 

12.     Larsson AK, Svalenius EC, Marsal K, et al. Parents’ worried state of mind when fetal ultrasound shows an unexpected finding: a comparative study. J Ultrasound Med 2009; 28: 1663–1670.

13.     Bensemlali M, Stirnemann J, Le Bidois J, et al. Discordances between pre-natal and post-natal diagnoses of congenital heart diseases and impact on care strategies. J Am Coll Cardiol 2016; 68: 921–30. 

14.     Persico N, Moratalla J, Lombardi CM, et al. Fetal echocardiography at 11-13 weeks by transabdominal high-frequency ultrasound. Ultrasound Obstet Gynecol 2011; 37(3): 296–301.

15.     Zidere V, Bellsham-Revell H, Persico N, Allan LD. Comparison of echocardiographic findings in fetuses at less than 15 weeks‘ gestation with later cardiac evaluation. Ultrasound Obstet Gynecol 2013; 42(6): 679–86. 

16.     Khoshnood B, Lelong N, Andrieu T, et al.; EPICARD Study Group. Assessing sociodemographic differences (or lack thereof) in prenatal diagnosis of congenital heart defects: a population-based study. BMJ Open 2016; 6(3): e009353. 

17.     Fouron JC, Proulx F, Gosselin J, Infante-Rivard C. Investigation of fetal arrhythmias by simultaneous recording of ascending aortic and superior vena caval blood flow. Arch Mal Coeur Vaiss 2001; 94: 1063–1071.

18.     Simpson JM, Sharland GK. Fetal tachycardias: management and outcome of 127 consecutive cases. Heart 1998; 79: 576–581.

19.     Naheed ZJ, Strasburger JF, Deal BJ, et al. Fetal tachycardia: mechanisms and predictors of hydrops fetalis. J Am Coll Cardiol 1996; 27(7): 1736–40.

20.     Sridharan S, Sullivan I, Tomek V, et al. Flecainide versus digoxin for fetal supraventricular tachycardia: Comparison of two drug treatment protocols. Heart Rhythm 2016; 13(9): 1913–1919.

21.     Ho YS, Esscher E, Anderson RH, et al. Anatomy of congenital complete heart block and relation to maternal anti-Ro antibodies. Am J Cardiol 1986; 58: 291–294.

22.     Cuneo BF, Sonesson SE, Levasseur S, et al. Home monitoring for fetal heart rhtyhm during anti-Ro pregnancies. J Am Coll Cardiol 2018; 72(16): 1940–51.

23.     Eliasson H, Sonesson SE, Sharland G, et al; for the Fetal Working Group of the European Associaion of Pediatric Cardiology. Isolated atrioventricular block in the fetus: a retrospective, multinational, multicenter study of 175 patients. Circulation 2011; 124(18): 1919–1926.

24.     Jaeggi E, Kulasingam V, Chen J, et al. Maternal anti-Ro antibody titers obtained with commercially available immunoassays are strongly associated with immune-mediated fetal heart disease. Arthritis Rheumatol 2023; 75(9): 1556–1565. 

25.     Izmirly PM, Custodeat-Chalumeau N, Pisoni CN, et al. Maternal use of of hydroxychloroquine is associated with a reduced risk of recurrent anti-SSA/Ro-antibody-associated cardiac manifestation of neonatal lupus. Circulation 2012; 125: 76–82. 

26.     Sedmera D, Pexieder T, Rychterova V, et al. Remodeling of chick embryonic ventricular myoarchitecture under experimentally changed loading conditions. Anat Rec 1999; 254: 238–252.

27.     Tulzer A, Arzt W, Gitter R, et al. Valvuloplasty in 103 fetuses with critical aortic stenosis: outcome and new predictors for postnatal circulation. Ultrasound Obstet Gynecol 2022; 59(5): 633–641. 

28.     Pickard SS, Wong JB, Bucholz EM, et al. Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome: A decision analysis. Circ Cardiovasc Qual Outcomes 2020; 13(4): e006271. 

Labels
Neonatology Paediatrics General practitioner for children and adolescents
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