Echocardiography in Pregnancy: Part 2

Narayanan, Meena; Elkayam, Uri; Naqvi, Tasneem Z.

doi:10.1007/s11886-016-0761-6

Cited by 16 publications

(9 citation statements)

References 57 publications

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“…At that time, the foetal cardiac structures can be defined more clearly with ultrasound screening in more than 90% of cases[ 43 ]. Foetal echocardiography is indicated in every case of gestational diabetes, especially in the presence of signs that increase the possibility of the presence of abnormal cardiac structures such as a persistent right umbilical vein, single umbilical artery, abnormal echogenic intracardiac foci, an aberrant right subclavian artery, or presence of foetal arrhythmia[ 44 ].…”

Section: Cardiac Evaluation Of Foetuses and Idmsmentioning

confidence: 99%

Cardiac changes in infants of diabetic mothers

Al‐Biltagi

Razaky

Amrousy

2021

WJD

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Diabetes mellitus (DM) is a systemic chronic metabolic disorder characterized by increased insulin resistance and/or β- cell defects. It affects all ages from the foetal life, neonates, childhood to late adulthood. Gestational diabetes is a critical risk factor for congenital heart diseases (CHDs). Moreover, the risk increases with low maternal education, high body mass index at conception, undiagnosed pre-gestational diabetes, inadequate antenatal care, improper diabetes control, and maternal smoking during pregnancy. Maternal DM significantly affects the foetal heart and foetal–placental circulation in both structure and function. Cardiac defects, myocardial hypertrophy are three times more prevalent in infants of diabetic mothers (IDMs). Antenatal evaluation of the cardiac function and structures can be performed with foetal electrocardiography and echocardiography. Postnatal cardiac evaluation can be performed with natal and postnatal electrocardiography and echocardiography, detection of early atherosclerotic changes by measuring aortic intima-media thickness, and retinal vascular changes by retinal photography. Ameliorating the effects of diabetes during pregnancy on the offspring depends mainly on pregestational and gestational diabetes prevention. However, other measures to reduce the risk, such as using medications, nutritional supplements, or probiotics, still need more research. This review discusses the mechanism of foetal sequels and the risk factors that increase the prevalence of CHDs in gestational DM, the various cardiac outcomes of gestational DM on the foetus and offspring, cardiac evaluation of foetuses and IDMs, and how to alleviate the consequences of gestational DM on the offspring.

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Section: Cardiac Evaluation Of Foetuses and Idmsmentioning

confidence: 99%

Cardiac changes in infants of diabetic mothers

Al‐Biltagi

Razaky

Amrousy

2021

WJD

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“…13 Its indications are to assess underlying congenital heart disease, heart valve disorders, a new nonphysiologic murmur, or a third or fourth heart sound. 14 Note. For pregnant women with heart disease, the CARPREG (Cardiac Disease in Pregnancy) II index is useful for preoperative evaluation (Table 2).…”

Section: Special Cardiovascular Assessment Not Usually Neededmentioning

confidence: 99%

Perioperative management of pregnant women undergoing nonobstetric surgery

Aurón

Castillo

García

2020

CCJM

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I mportant physiologic changes take place during pregnancy that optimize maternal and fetal outcomes but increase risk during surgery. Accommodating normal changes and identifying and managing risk factors should guide perioperative planning.This article reviews physiologic changes in pregnancy, implications for perioperative management of nonobstetric surgery, and practical notes for clinical management. ■ NONOBSTETRIC SURGERY IN PREGNANCY IS RARE AND RISKYFrom 0.2% to 2.0% of pregnant women undergo nonobstetric surgery. 1,2 In order of frequency, the most common procedures are appendectomy, cholecystectomy, adnexal surgery (for torsion or masses), trauma repair, small-bowel obstruction surgery, and breast surgery. [2][3][4] The American College of Surgeons National Surgical Quality Improvement Program reported a postoperative complication rate of 5.8% in pregnancy. Complications included reoperation within 30 days (3.6%), infections (2%), wound problems (1.4%), respiratory complications (2%), thromboembolic complications (0.5%), transfusion requirements (0.2%), and death (0.25%). 4 A study of 5,591 pregnant women in Taiwan 5 found that the rates of the following postoperative complications were higher than among nonpregnant women: • Sepsis (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.47-2.07) • Pneumonia (OR 1.47, 95% CI 1.01-2.13

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“…It was reported that the primary cause of mortality from birth defects was related to the structure or function of the heart lesion [ 3 ]. The incidence of CHD was reported to be common among older mothers [ 4 ]. However, the pathogenesis of the CHD is extremely complex and the association between maternal age and CHD has not been confirmed yet.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Echocardiography and 64-Multislice Spiral Computed Tomography for the Diagnosis of Pediatric Congenital Heart Disease

Peng

Zhang

2017

Med Sci Monit

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BackgroundThe goals of this study were: to compare echocardiogram and 64-multislice spiral computed tomography (64-MSCT) in diagnosing pediatric congenital heart disease; to determine the significance of ECHO for diagnosing congenital heart disease; and to identify the appropriate diagnosis for congenital heart disease through combined use of 64-MSCT and ECHO.Material/MethodsThirty patients underwent both ECHO and 64-MSCT diagnoses before their surgeries. Imaging from ECHO and 64-MSCT were analyzed by 4 specialists. The diagnostic accuracy and kappa value of ECHO and 64-MSCT were evaluated based on the operation results. The accuracy of the 2 methods was evaluated using the McNemar χ2 test.ResultsWe confirmed 138 malformations in 30 children by surgery. The diagnostic accuracy of ECHO and 64-MSCT was 98.40% and 96.20%, respectively, with a significant difference between the 2 results (χ2=6.404, P=0.011). We compared prognosis accuracy and uniformity on 3 types of congenital heart disease (cardiac malformation, heart-large vascular connecting malformation, and large vascular malformation): 56 cardiac malformations were confirmed by surgery, in which the diagnostic accuracy of ECHO and 64-MSCT was 99.50% and 94.80%, respectively. (χ2=8.578, P=0.034); 31 heart-large vascular connecting malformations were confirmed by surgery, in which the diagnostic accuracy of ECHO and 64-MSCT was 99.00% and 95.42% (χ2=6.779, P=0.009); and 51 vascular malformations were confirmed, in which the diagnostic accuracy of ECHO and 64-MSCT was 96.30% and 98.30% (χ2=1.806, P=0.179).ConclusionsECHO is more effective than 64-MSCT in preoperative diagnosis of congenital heart disease, especially for children.

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Echocardiography in Pregnancy: Part 2

Cited by 16 publications

References 57 publications

Cardiac changes in infants of diabetic mothers

Cardiac changes in infants of diabetic mothers

Perioperative management of pregnant women undergoing nonobstetric surgery

Comparison of Echocardiography and 64-Multislice Spiral Computed Tomography for the Diagnosis of Pediatric Congenital Heart Disease

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