Impact of prenatal diagnosis of transposition of the great arteries on obstetric and early postnatal management

Raboisson, Marie‐Josée; Samson, Charles M.; Ducreux, Corinne; Rudigoz, R.-C.; Gaucherand, P.; Bouvagnet, Patrice; Bozio, A

doi:10.1016/j.ejogrb.2008.09.001

Cited by 42 publications

(32 citation statements)

References 12 publications

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“…prostaglandin infusion and BAS) in the high-risk patients. On the other hand, as previously reported, prenatal diagnosis of dTGA is also responsible of increasing the incidence of cesarean section or induced labor at 38-39 weeks of gestation, in order to ensure that delivery takes place under controlled conditions with cardiologists and cardiac intensivists immediately available [8,24] .…”

Section: Discussionmentioning

confidence: 80%

Prenatal Echocardiographic Assessment of Foramen Ovale Appearance in Fetuses with <smlcap>D</smlcap>-Transposition of the Great Arteries and Impact on Neonatal Outcome

et al. 2016

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Introduction: Neonates with D-transposition of the great arteries (dTGA) may die at birth because of the inadequate intracardiac mixing due to a misdiagnosed restrictive foramen ovale. We reviewed our experience in echocardiographic assessment and perinatal management of fetuses with dTGA searching for new features that may predict the need for urgent balloon atrial septostomy (BAS) immediately after birth. Patients and Methods: We included fetuses diagnosed with dTGA between January 2000 and December 2014. We assessed pre- and postnatal appearance of the foramen ovale, ductus arteriosus and pulmonary veins. Both the diagnostic findings at the time of last prenatal echocardiogram and those findings deriving from a retrospective reevaluation of stored videos were considered. BAS was defined as urgent if performed in neonates with restrictive foramen ovale and severe hypoxemia. Results: We reviewed 40 fetuses with dTGA. 20/40 fetuses received urgent BAS at birth. Not only the restrictive but also the hypermobile and the redundant appearance of the foramen ovale was significantly associated with urgent BAS (p < 0.0001, p = 0.002 and p = 0.0001, respectively). Conclusions: Prenatal evaluation of the foramen ovale appearance in fetuses with dTGA is still challenging. Based on our experience, also the redundant foramen ovale appearance may need urgent BAS at birth.

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Section: Discussionmentioning

confidence: 80%

Prenatal Echocardiographic Assessment of Foramen Ovale Appearance in Fetuses with <smlcap>D</smlcap>-Transposition of the Great Arteries and Impact on Neonatal Outcome

et al. 2016

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“…7 Noutros estudos, tem sido difícil comprovar esse benefício. 10,11 Uma possível explicação para esse facto poderá resultar da heterogeneidade das CCC e das diferentes taxas de sobrevivência para cada patologia. Restringindo--se a amostra a determinadas cardiopatias congénitas, observa-se uma melhoria no prognóstico a curto e longo prazo quando há DPN.…”

Section: Discussionunclassified

Cardiopatias Congénitas Complexas: Influência do Diagnóstico Pré-Natal

Correia

Fortunato²,

Martins

et al. 2015

Acta Med Port

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Introduction:Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease. Material and Methods:Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012. Results: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%) were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality. Discussion: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease. Conclusion: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease weren't diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease. Keywords: Heart Defects, Congenital; Prenatal Diagnosis. INTRODUÇÃOAs cardiopatias congénitas são as malformações congénitas major mais comuns e constituem o grupo com maior relevância clínica, com uma prevalência de 0,5% a 1% no período neonatal.1-3 Cerca de metade destas cardiopatias são graves e necessitam de intervenção no período neonatal ou nos primeiros anos de vida. 2As cardiopatias congénitas complexas (CCC) constituem um grupo de doenças graves e incluem na sua grande maioria uma alteração do arranjo segmentar, sendo exemplos o síndrome de coração esquerdo hipoplásico (SCEH), transposição das grandes artérias (TGA) e o coração univentricular. De entre as cardiopatias congénitas,

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“…An impact of prenatal diagnosis on mode of delivery is also shown in cases of TGA 48 . Induction of labour and rate of caesarean section were about 2.5 and 3 times higher in cases diagnosed prenatally, respectively.…”

Section: Mode Of Delivery and Chdmentioning

confidence: 94%

“…For women who were induced, this occurred earlier in the prenatal (38.7 weeks) compared to postnatal group (40.2 weeks). Apart from earlier ICU admission, mode of delivery had no impact on neonatal outcome 48 . Similarly, Peterson et al studied neonates with antenatal diagnosis of HLHS who were delivered in >37 weeks 49 .…”

Section: Mode Of Delivery and Chdmentioning

confidence: 99%