OC19.01: The impact of periconceptional parental alcohol exposure on embryonic growth trajectories using 3D ultrasound and virtual reality

Abstract

Objectives: Invasive fetal cardiac intervention (FCI) for relief of severe semilunar valve stenosis or atrial restriction has been performed with varying technical and physiologic success reported in small series. We created an international registry of cases presenting for possible FCI with the intention of compiling experience, technical aspects, and outcomes data. Here we report the current status of the registry and activity since the initial descriptions in 2014/15. Methods: The International Fetal Cardiac Intervention Registry (IFCIR) was established in 2010 to collect voluntarily submitted diagnostic and procedure-related data. Maternal-fetal dyads referred from 2001 onward for possible FCI are included. For the purpose of this interim descriptive analysis, the database was queried for all entries, details of diagnosis, procedures performed, and pregnancy and neonatal outcomes. Results: Since the initial report an additional 328 have been entered, for a total of 700; this includes information for 452 who had an attempt at FCI. The majority are valvuloplasties--aortic (322) or pulmonary (64), with atrial septoplasty and/or stent placement (60), and other (6). Overall procedure-related fetal loss was 50/452(11%). All procedures after 2013 were done percutaneously, with no maternal deaths or major complications recorded. Preterm delivery occurred in 69 of 291 (24%) live-born infants with this data. Among live-born infants, favorable physiologic status (biventricular circulation for valve procedures, survival to discharge for septal procedures) was noted in 67% with this information entered. Conclusions: Our results from retrospective data collection suggest a potential benefit to fetal cardiac intervention, though procedure-related loss was not trivial. Analyses of data pertaining to specific diseases and patient and procedural variables are ongoing and analysis of the relationship of centre/operator experience with FCI success is being investigated through this large collaborative effort.