Longitudinal functional assessment of atrial M‐mode in dextro‐ transposition of the great arteries fetus may help to predict the necessity for urgent neonatal Rashkind procedure

Respondek‐Liberska, Maria; Sylwestrzak, Oskar

doi:10.1111/echo.15422

Cited by 1 publication

(1 citation statement)

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“…Fetal echocardiography has a special aim depending on the stage of pregnancy. Third-trimester fetal echocardiography, performed close to the delivery term, provides a lot of information regarding the neonatal cardiovascular condition and this subject has been studied widely in case of fetal CHD [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. However, when normal heart anatomy is found, commonly asked questions include: does fetal echocardiography provide any additional value to obstetricians or neonatologists in the case of normal fetal heart anatomy?…”

Section: Introductionmentioning

confidence: 99%

Fetal Third-Trimester Functional Cardiovascular Abnormalities and Neonatal Elevated Bilirubin Level

Respondek-Liberska,

Sylwestrzak,

Murlewska

et al. 2023

JCM

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Background: The aim of the study was to analyze the neonatal outcomes of fetuses with diagnosed functional cardiovascular abnormalities, also considering the connection with neonatal hyperbilirubinemia. Materials and Methods: It was an observational study of 100 neonates who had fetal echocardiography examinations in the third trimester (mean gestational age during the last echocardiography was 34 ± 3 weeks and mean birth weight was 3550 g). There were two groups: A: normal heart anatomy + no functional anomalies; group B: normal heart anatomy + functional abnormalities. Hyperbilirubinemia was defined as a bilirubin level of >10 mg%. Results: In group A, there were 72 cases and only 5 cases despite having normal heart anatomy and normal heart study that presented additional problems. In group B (28 cases), the prenatal functional findings included tricuspid regurgitation (TR) (15 cases, 53%), pericardial effusion (4 cases, 14%), myocardial hypertrophy (4 cases, 14%), cardiomegaly (2 cases, 7%), abnormal bidirectional blood flow across the foramen ovale (3 cases, 11%), aneurysm of atrial septum (2 case, 7%), abnormal E/A ratio for mitral and tricuspid valve (1 case, 3%), bright spot (3 case, 11%), abnormal Doppler flow in ductus arteriosus compared to aortic arch (difference >60 cm/s) (1 case, 3%), supraventricular tachycardia (SVT) (1 case), and mitral regurgitation (1 case, 3%). In group A (n = 72 cases), bilirubin levels of >10 mg/dL were observed in 8% of newborns. In group B (n = 28), bilirubin levels of > 10 m/dL were observed in 46% of cases and TR was present in group B in 53% of cases (15/28 cases). The difference between group A and B in terms of elevated bilirubin levels was statistically significant (p < 0.001). Conclusions: In the case of fetal normal heart anatomy and normal heart study, a good neonatal outcome may be expected. When fetal cardiovascular functional abnormalities in normal heart anatomy are detected, with special attention paid to tricuspid valve regurgitation, a neonatal elevated bilirubin level (mean 11 mg/dL, range 10–15 mg/dL) may be expected.

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