Objective: To evaluate the long-term follow-up of patients with fetal cardiac tumors (FCTs), and to review the literature regarding advances in diagnosis and management of FCTs in the last decade. Material and Methods: In this retrospective study, pregnant women referred to a single center maternal-fetal medicine unit between 2013 and 2018 for advanced ultrasonography, were reviewed. Pediatric cardiology counseling was offered to women whose fetuses had FCTs. All patients were evaluated according to revised diagnostic criteria for tuberous sclerosis complex (TSC). Medical treatment was administered to patients with FCTs ≥30 mm or if they were symptomatic. Everolimus therapy at a dose of 2x0.25 mg twice a week for three months was started in the postnatal period. Results: Out of the 75,312 patients referred 18 (0.024%) were diagnosed with FCTs. Six were referred with fetal arrhythmias and the others were diagnosed with FCTs during routine follow-up. Ten patients (55%) with FCTs were diagnosed with TSC. All tumors were assessed to be rhabdomyoma. Mean tumor diameter in fetuses with TSC was significantly larger than those without TSC (29.8±14.1 mm versus 9.3±4.8 mm, respectively; p=0.004). All patients (n=2) who received medical therapy had a diagnosis of TSC and multiple FCTs and a reduction in tumor size occurred. Tumor size decreased in eight patients spontaneously during follow-up, but increased in one patient who had multiple locations but no TCS. No change in size was observed in the remaining seven cases. None of the fetuses died during the 1-5 year follow-up period. Conclusion: Rhabdomyoma are usually multiple and associated with TSC. Rhabdomyomas with TSC are larger, but most regress spontaneously or respond well to medical treatment after birth, and have an excellent long-term prognosis.
Objective: Adolescent pregnancies are more severe and dangerous for both mother and baby than adult pregnancies. Low birth weight, infections, intrauterine growth restriction, sudden infant death syndrome, and death risk are higher in neonates of adolescent pregnant women. Besides, anomalies of central nervous, gastrointestinal, and musculoskeletal systems are also seen frequently. The purpose of this study is to investigate congenital malformations of infants born from adolescent mothers. In this study, malformations were grouped according to the systems. Material and Methods: In this retrospective study, 166 pregnant women aged 18 and under who had fetal anomaly were included in the study and their charts reviewed. Descriptive information about the adolescents and information about the fetuses and anomalies were recorded. Maternal and neonatal characteristics were calculated as frequency and percentage. Results: The most common anomalies were the central nervous (40.5%), cardiovascular (15.8%), and urinary (10.8%) system. The anomalies related to the skin and phalanges, including the face, accounted for 8.1% of the cases. Ventricular dilatation (10,4%), neural tube defect (7,2%), and hydrocephalus (7,2%) were the most common abnormalities of the central nervous system. Ventricular septal defect (5,9%), pulmonary artery anomaly (2,7%), and tricuspid valve anomaly (2,3%) were the most common cardiovascular system anomalies. Intrauterine growth restriction (3,6%), pleural effusion/hydrothorax (3,2%), pes equinovarus (2,7%), diaphragmatic hernia (2,3%), cystic hygroma (2,3%), oligohydramnios (2,3%), polyhydramnios (2,3%), and cleft palate/lip (2,3%) were the most common anomalies among the other system and organ anomalies. Conclusion: Adolescent pregnancy was partially associated with an increased risk of severe neonatal anomalies especially in the central nervous, cardiovascular, and urinary systems. Pediatric health care providers should have a low threshold for suspecting pregnancy in adolescents.
Objective To determine if fetal MR alters the management of pregnancy and family decisions in the isolated corpus callosum agenesis (CCA) cases or not. Methods Fetal MR was carried out in the cases diagnosed with CCA in the Perinatology Unit of our hospital between 2013 and 2019 after they were differentiated as complex and isolated CCA cases. The impact of MR results on the family decisions and their approaches towards termination were assessed. Results A total of 109 out 139 cases were evaluated as isolated CCA. While 93 (85.32%) of them were diagnosed with the complete CCA, 16 (14.68%) cases were diagnosed with the partial CCA. When the period after 2017 during which fetal MR was recommended to all patients was reviewed, it was seen that 7 (23.3%) of 30 cases who underwent fetal MR and 2 (20%) of 10 cases who did not undergo fetal MR terminated their pregnancies. There was no statistical difference between two groups in terms of the decisions of the patients for gestational termination who did and did not undergo fetal MR. Conclusion Fetal MR imaging in the isolated CCA does not change the decisions of the families for the gestational termination. In terms of the termination decision, week of gestation and socio-cultural factors may have more impacts.
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