The role of echocardiography in fetal tachyarrhythmia diagnosis. A burden for the pediatric cardiologist and a review of the literature.

Gozar, Liliana; Mărginean, Cristina Oana; Togănel, Rodica; Muntean, Iolanda

doi:10.11152/mu-892

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…Fetal malformations present multidisciplinary involvements regarding the diagnosis, the therapeutic approach and the prognosis [18][19][20][21][22][23][24][25][26][27][28]. Therefore, prenatal diagnosis is the cornerstone factor that can influence the prognosis of these fetuses.…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of cleft lip and cleft lip palate – a case series

et al. 2018

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Aim: Orofacial clefts comprise cleft lip (CL) or cleft lip-palate (CLP) and are the most frequently encountered malformation of the facial region, accounting for approximately 1-2.2/1,000 live births. The aim of this study was to reveal the particularities regarding the prenatal diagnosis of orofacial clefts in a series of 11 cases diagnosed in a tertiary center.Material and methods: The study was performed in a tertiary diagnostic center for a period of 8 years (January 2010 – December 2017), on8125 patients that were assessed for screening or suspicion of malformations.Results: During the assessed period a number of 11 fetuses (0.13%) were diagnosed by 2D and 3D ultrasound with CL (4 cases) or CLP (7 cases). The smallest gestational age at diagnosis was of 14 weeks, whereas the highest was 35 weeks. Of the 7 cases diagnosed with CLP, 4 presented also other associated anomalies that involved the central nervous system, the kidney, the skeleton and the stomach. All 4 cases of CL had identifiable associated anomalies. Termination of pregnancy was encountered in 3 cases with CLP.Conclusions: CLP can be diagnosed even at the end of the 1st trimester of pregnancy. CL is usually diagnosed during the 2nd trimester ultrasound exam and is commonly an isolated anomaly.

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Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of cleft lip and cleft lip palate – a case series

et al. 2018

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“… 16 More critically, there is an insufficient number of pediatric cardiologists or congenital cardiac sonographers who are experienced in performing a comprehensive cardiac ultrasound. 17 Pulse oximetry has been recommended as a reliable screening tool of CHD for newborns in a number of developed countries. 18 – 21 Nevertheless, several recent pioneering studies have obtained an extremely high specificity, but only a moderate sensitivity, of pulse oximetry in detecting CHD.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of pulse oximetry combined with cardiac auscultation in screening congenital heart disease in neonates

et al. 2021

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Objective This study aimed to investigate the feasibility and reliability of pulse oximetry combined with cardiac auscultation in screening neonatal congenital heart disease (CHD). Methods This was a retrospective, observational, screening study. All newborns included in the study were at the Second Affiliated Hospital of Wenzhou Medical University from July 2019 to January 2020. Primary screening of CHD was conducted by pulse oximetry combined with cardiac auscultation assays. Indices, including sensitivity, specificity, the positive/negative predictive value, the positive/negative likelihood ratio, and the diagnostic odds ratio, were calculated. The area under the relative operating characteristic curve of the subjects was measured. Results A total of 3327 neonates were enrolled, among whom 139 were diagnosed with CHD and the incidence of CHD was 4.2%. The sensitivity, specificity, diagnostic odds ratio, and area under the relative operating characteristic curve of pulse oximetry combined with cardiac auscultation were 89.9%, 94.7%, 169.0, and 0.923, respectively. Conclusions Pulse oximetry combined with cardiac auscultation is a novel screening method with acceptable accuracy and feasibility for neonatal CHD. This combination method is worth promoting widely.

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“…In a non-randomized prospective study on 100 fetuses at 15-40 weeks of gestation for cardiac referal, 45 fetuses had cardiac arrhythmias, including premature atrial contractions (PACs) (28/45, 62.2%), atrial bigeminal ectopic beats (3/45, 6.7%), premature ventricular contractions (PVCs) (2, 4.4%), supraventricular tachycardia (SVT) (5/45, 11.1%), ventricular tachycardia (1, 2.2%), second-degree atrioventricular (AV) block (1, 2.2%) and complete AV block (5/45, 11.1%) [3]. A 10-year observational study on the pregnant women demonstrated 29 cases of fetal arrhythmias: 12 (41.4%) of which were fetal tachycardias (10 cases with SVT, 2 cases with atrial flutter (AF)), 5 (17.2%) were fetal bradyarrhythmias (all 5 cases with AV block), and 12 (41.4%) were fetal irregular cardiac rhythms (premature atrial beats) [4]. The overall incidence of malignant fetal arrhythmias, such as complete AV block and SVT, are relatively rare, found in 1:5000 pregnancies [5].…”

Section: Introductionmentioning

confidence: 99%

Fetal arrhythmias: prenatal evaluation and intrauterine therapeutics

Yuan

2020

Ital J Pediatr

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Introduction: Fetal arrhythmias are a common phenomenon with rather complicated etiologies. Debates remain regarding prenatal diagnosis and treatment of fetal arrhythmias. Methods:The literature reporting on prenatal diagnosis and treatment of fetal arrhythmias published in the recent two decades were retrieved, collected and analyzed. Results: Both fetal magnetocardiogram and electrocardiogram provide information of cardiac time intervals, including the QRS and QT durations. M-mode ultrasound detects the AV and VA intervals, fetal heart rate, and AV conduction. By using Doppler ultrasound, simultaneous recording of the atrial and ventricular waves can be obtained. Benign fetal arrhythmias, including premature contractions and sinus tachycardia, do not need any treatment before and after birth. Sustained fetal arrhythmias that predispose to the occurrence of hydrops fetalis, cardiac dysfunction or eventual fetal demise require active treatments. Intrauterine therapy of fetal tachyarrhythmias has been carried out by the transplacental route. If maternal transplacental treatment fails, intraumbilical, intraperitoneal, or direct fetal intramuscular injection of antiarrhythmic agents can be attempted. Conclusions: The outcomes of intrauterine therapy of fetal tachyarrhythmias depend on the types or etiology of fetal arrhythmias and fetal conditions. Most are curable to a transplacental treatment by the first-line antiarrhythmic agents. Fetal cardiac pacings are effective methods to restore sinus rhythm in drug-resistant or hemodynamically compromised cases. Immediate postnatal pacemaker implantation is warranted in refractory cases.

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The role of echocardiography in fetal tachyarrhythmia diagnosis. A burden for the pediatric cardiologist and a review of the literature.

Cited by 6 publications

References 17 publications

Prenatal diagnosis of cleft lip and cleft lip palate – a case series

Prenatal diagnosis of cleft lip and cleft lip palate – a case series

Diagnostic value of pulse oximetry combined with cardiac auscultation in screening congenital heart disease in neonates

Fetal arrhythmias: prenatal evaluation and intrauterine therapeutics

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