A. Goel, C. Reyes, Shauna Mclaughlin, M. Wittry, A. Fiore
Abstract Retroesophageal course of the left brachiocephalic vein is a rare variant seen in patients with congenital heart disease. However, this anomaly without associated cardiac or aortic abnormalities is nearly unheard of, with only one prior case described in the literature. We present an infant with anomalous retroesophageal left brachiocephalic vein that was an incidental finding on computed tomography (CT). We also briefly discuss its embryologic and clinical significance.
{"title":"Case report. Retroesophageal Left Brachiocephalic Vein in an Infant Without Cardiac Anomalies","authors":"A. Goel, C. Reyes, Shauna Mclaughlin, M. Wittry, A. Fiore","doi":"10.1515/pcard-2016-0012","DOIUrl":"https://doi.org/10.1515/pcard-2016-0012","url":null,"abstract":"Abstract Retroesophageal course of the left brachiocephalic vein is a rare variant seen in patients with congenital heart disease. However, this anomaly without associated cardiac or aortic abnormalities is nearly unheard of, with only one prior case described in the literature. We present an infant with anomalous retroesophageal left brachiocephalic vein that was an incidental finding on computed tomography (CT). We also briefly discuss its embryologic and clinical significance.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124136261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The hydropic fetus with atrial flutter has high risk of fetal demise. In utero treatment is not as successful as SVT with 1:1 conduction. Even after conversion to sinus rhythm, close follow-up of the pregnancy is required for several reasons.. Case Report: A 25 year old primigravida, at 26 wks of gestation had a fetal ultrasound which showed a tachycardic hydropic fetus with AFI 49. The rhythm was atrial flutter: AR 400 bpm and VR 200 bpm. The heart was structurally normal. Transplacental antiarrhythmic treatment with sotalol was started and 24 hours later, the fetus was still primarily in flutter with rare episodes of sinus rhythm and frequent PAC. Sotalol was increased but the mother’s QTc increased to > 500 ms, so the sotalol dose was reduced. On day 4th direct i.m. of digoxin was given and fetus was in sinus rhythm. Pharmacotherapy was continued. On the 16th day of sinus rhythm (at 33 wks), a marked change in FHR variability was seen. An US revealed the fetus was in sinus rhythm with a normal FHR. Because of the decreased FHR variability, the fetus was delivered by CS and the cord pH was 7.19, Apgars 1, 9 and 9. The neonate received no antiarrhythmic medications. On day 6 of postnatal life, an AV re-entrant tachycardia (AVRT) developed and sinus rhythm was successfully restored with sotalol and digoxin. The infant was treated for 18 months with no episodes of SVT or atrial flutter.
{"title":"Fetal Atrial Flutter and Hydrops Successfully Treated with Transplacental and Direct Fetal Therapy","authors":"B. Cuneo","doi":"10.1515/pcard-2016-0002","DOIUrl":"https://doi.org/10.1515/pcard-2016-0002","url":null,"abstract":"Abstract The hydropic fetus with atrial flutter has high risk of fetal demise. In utero treatment is not as successful as SVT with 1:1 conduction. Even after conversion to sinus rhythm, close follow-up of the pregnancy is required for several reasons.. Case Report: A 25 year old primigravida, at 26 wks of gestation had a fetal ultrasound which showed a tachycardic hydropic fetus with AFI 49. The rhythm was atrial flutter: AR 400 bpm and VR 200 bpm. The heart was structurally normal. Transplacental antiarrhythmic treatment with sotalol was started and 24 hours later, the fetus was still primarily in flutter with rare episodes of sinus rhythm and frequent PAC. Sotalol was increased but the mother’s QTc increased to > 500 ms, so the sotalol dose was reduced. On day 4th direct i.m. of digoxin was given and fetus was in sinus rhythm. Pharmacotherapy was continued. On the 16th day of sinus rhythm (at 33 wks), a marked change in FHR variability was seen. An US revealed the fetus was in sinus rhythm with a normal FHR. Because of the decreased FHR variability, the fetus was delivered by CS and the cord pH was 7.19, Apgars 1, 9 and 9. The neonate received no antiarrhythmic medications. On day 6 of postnatal life, an AV re-entrant tachycardia (AVRT) developed and sinus rhythm was successfully restored with sotalol and digoxin. The infant was treated for 18 months with no episodes of SVT or atrial flutter.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124136635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.5114/PCARD.2020.98347
V. Tsibizova, T. Pervunina, E. Komlichenko, I. Govorov, I. Averkin, A. Makatsariya, G. C. Renzo
is an important issue in order to understand the modifications that any intervention aimed to solve the blood transfusion can determine on the surviving fetuses. Many studies have shown that in the long term, after laser coagulation (LC) of severe TTTS syndrome, cardiac function and blood pressure return to normal in the majority of surviving twins. This indicates that the preceding cardiac dysfunction regresses once LC has removed the underlying cause. However, a reported increased in the prevalence of pulmonary stenosis despite successful LC justifies the need for prenatal and postnatal cardiac surveillance. Material and methods: In our data of 28 pairs of twins complicated by TTTS and undergoing LC, we observed abnormal prenatal cardiac findings before treatment and the postnatal occurrence of some structural heart defects. One twin recipient with hydrops and functional pulmonary atresia had the same features at postnatal follow-up; another twin recipient with fetal hydrops, and mitral and tricuspid valve regurgitation presented with moderate pulmonary stenosis postnatally. Results: One fifth of all TTTS recipient twins show congenital and/or acquired diseases, i.e. right ventricle outflow tract obstruction (RVOTO), PA, or PS. Laser coagulation in severe stages can solve the blood transfusion but does not solve the acquired CHD (such as right ventricular outflow obstruction and pulmonary valve atresia). Conclusions: Laser coagulation should always be performed before cardiac function deteriorates, if possible.
{"title":"Cardiac function in TTTS twins after laser coagulation","authors":"V. Tsibizova, T. Pervunina, E. Komlichenko, I. Govorov, I. Averkin, A. Makatsariya, G. C. Renzo","doi":"10.5114/PCARD.2020.98347","DOIUrl":"https://doi.org/10.5114/PCARD.2020.98347","url":null,"abstract":"is an important issue in order to understand the modifications that any intervention aimed to solve the blood transfusion can determine on the surviving fetuses. Many studies have shown that in the long term, after laser coagulation (LC) of severe TTTS syndrome, cardiac function and blood pressure return to normal in the majority of surviving twins. This indicates that the preceding cardiac dysfunction regresses once LC has removed the underlying cause. However, a reported increased in the prevalence of pulmonary stenosis despite successful LC justifies the need for prenatal and postnatal cardiac surveillance. Material and methods: In our data of 28 pairs of twins complicated by TTTS and undergoing LC, we observed abnormal prenatal cardiac findings before treatment and the postnatal occurrence of some structural heart defects. One twin recipient with hydrops and functional pulmonary atresia had the same features at postnatal follow-up; another twin recipient with fetal hydrops, and mitral and tricuspid valve regurgitation presented with moderate pulmonary stenosis postnatally. Results: One fifth of all TTTS recipient twins show congenital and/or acquired diseases, i.e. right ventricle outflow tract obstruction (RVOTO), PA, or PS. Laser coagulation in severe stages can solve the blood transfusion but does not solve the acquired CHD (such as right ventricular outflow obstruction and pulmonary valve atresia). Conclusions: Laser coagulation should always be performed before cardiac function deteriorates, if possible.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"351 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120882009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.5114/PCARD.2020.102253
C. Luchi, I. Natali, M. Caputo, Stella Zandri, S. Taddei, F. Monacci, G. Posar, T. Simoncini
Introduction: Pregnancy-associated plasma protein A (PAPP-A) protease is known for its role as a key regulator of insulin-like growth factors and hence of foetal development. With the present study we intend to investigate its role in the maternal haemodynamic adaptation to the state of pregnancy. Material and methods: We selected 18 patients referred to our unit between February 2017 and July 2017, of whom 10 showed low PAPP-A values at the first trimester screening for chromosomal anomalies. Each patient had 3 serial echocardiographic evaluations at the 13 th , 24 th , and 33 rd week of pregnancy. On the basis of the plasma values of PAPP-A, the patients were divided into cases ( n = 10) and controls ( n = 8), where cases had a mean PAPP-A concentration of 0.345 with a standard deviation of 0.086, while the controls were characterised by a mean PAPP-A concentration of 1.380 with a standard deviation of 0.613. The main outcome measures were peripheral vascular resistance (PVR), cardiac output (CO), systolic excursion of the tricuspid ring (TAPSE), and E/E’ ratio. Systolic and diastolic arterial blood pressure and heart rate (HR) were measured at each visit. Mono- and bidimensional, Doppler, and TDI images were acquired and analysed blindly by a single sonographer. Results: A slight increase in heart rate (HR, + 12%, p < 0.05) was observed in the control group at the 33 rd week visit, while there was no change in the group with low levels of PAPP-A. Cardiac output and PVR also changed in the high-value PAPP-A group (ANOVA for repeated measures, p < 0.05), while they remained unchanged in the group with low PAPP-A values. It was observed that in the case group, the lower the PAPP-A values, the lower the extent of the haemodynamic adjustment in terms of PVR drop and increase in CO. A lack of physiological adaptation to pregnancy was also observed in the systolic function of the right ventricle. Women with normal PAPP-A showed a slight reduction ( t test, p < 0.05) of TAPSE, while in women with low PAPP-A no change was observed. The E/E’ ratio was significantly increased in the control group at the last two visits ( p < 0.005 and p < 0.05, respectively). Conclusions: This study shows that the physiological haemodynamic adaptation and the morphofunctional changes in the heart are incomplete in women with low PAPP-A levels, creating a favourable substrate for the development of preeclampsia. The assay of PAPP-A in the first trimester can therefore be used as a screening method to select at-risk pregnancies, with the aim of creating a specific path and a closer follow-up. Abstract
{"title":"Maternal heart examination in pregnancy affected by low PAPP-A MoM in the first trimester","authors":"C. Luchi, I. Natali, M. Caputo, Stella Zandri, S. Taddei, F. Monacci, G. Posar, T. Simoncini","doi":"10.5114/PCARD.2020.102253","DOIUrl":"https://doi.org/10.5114/PCARD.2020.102253","url":null,"abstract":"Introduction: Pregnancy-associated plasma protein A (PAPP-A) protease is known for its role as a key regulator of insulin-like growth factors and hence of foetal development. With the present study we intend to investigate its role in the maternal haemodynamic adaptation to the state of pregnancy. Material and methods: We selected 18 patients referred to our unit between February 2017 and July 2017, of whom 10 showed low PAPP-A values at the first trimester screening for chromosomal anomalies. Each patient had 3 serial echocardiographic evaluations at the 13 th , 24 th , and 33 rd week of pregnancy. On the basis of the plasma values of PAPP-A, the patients were divided into cases ( n = 10) and controls ( n = 8), where cases had a mean PAPP-A concentration of 0.345 with a standard deviation of 0.086, while the controls were characterised by a mean PAPP-A concentration of 1.380 with a standard deviation of 0.613. The main outcome measures were peripheral vascular resistance (PVR), cardiac output (CO), systolic excursion of the tricuspid ring (TAPSE), and E/E’ ratio. Systolic and diastolic arterial blood pressure and heart rate (HR) were measured at each visit. Mono- and bidimensional, Doppler, and TDI images were acquired and analysed blindly by a single sonographer. Results: A slight increase in heart rate (HR, + 12%, p < 0.05) was observed in the control group at the 33 rd week visit, while there was no change in the group with low levels of PAPP-A. Cardiac output and PVR also changed in the high-value PAPP-A group (ANOVA for repeated measures, p < 0.05), while they remained unchanged in the group with low PAPP-A values. It was observed that in the case group, the lower the PAPP-A values, the lower the extent of the haemodynamic adjustment in terms of PVR drop and increase in CO. A lack of physiological adaptation to pregnancy was also observed in the systolic function of the right ventricle. Women with normal PAPP-A showed a slight reduction ( t test, p < 0.05) of TAPSE, while in women with low PAPP-A no change was observed. The E/E’ ratio was significantly increased in the control group at the last two visits ( p < 0.005 and p < 0.05, respectively). Conclusions: This study shows that the physiological haemodynamic adaptation and the morphofunctional changes in the heart are incomplete in women with low PAPP-A levels, creating a favourable substrate for the development of preeclampsia. The assay of PAPP-A in the first trimester can therefore be used as a screening method to select at-risk pregnancies, with the aim of creating a specific path and a closer follow-up. Abstract","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"649 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123971178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Respondek-Liberska, J. Płużańska, K. Zych-Krekora, E. Czichos, M. Słodki, J. Moll
Abstract From 2012-2014 we selected fetuses who had an isolated congenital heart defect and restriction of the foramen ovale defined as its diameter of 4 mm or less, shunt across foramen ovale, V max > 70 cm/sec along with a typical harsh sound during fetal ausculation during echocardiography and reversal flow in pulmonary veins, no extracardiac anomalies, singleton pregnancies and delivery > 37 weeks of gestation. It was retrospective analysis of 16 cases: There were 10 non-survivors and 6 survivors The only significant difference between survivors and non-survivors pertained to the fraction of newborns operated on up to 11th day, which was significantly higher among the survivors (5/6 vs. 2/8, p=0.031). Conclusions: 1) In the event of prenatal restriction of the foramen ovale early surgery by day 10 had a statistically better outcome in terms of survival compared to cases that underwent surgery at a later period at our Institute. 2) Prenatal restriction of the foramen ovale was more often related to male gender and in 75% of cases in our series had complicated follow-up: neonatal death or prolonged hospital stay.3) Information from prenatal echocardiography regarding restriction of the foramen ovale should be taken into consideration as valuable information suggesting priority for early cardiac surgery.
{"title":"Early neonatal surgery for congenital heart defects after prenatal diagnosis of restricted foramen ovale as the priority procedure?","authors":"M. Respondek-Liberska, J. Płużańska, K. Zych-Krekora, E. Czichos, M. Słodki, J. Moll","doi":"10.12847/09155","DOIUrl":"https://doi.org/10.12847/09155","url":null,"abstract":"Abstract From 2012-2014 we selected fetuses who had an isolated congenital heart defect and restriction of the foramen ovale defined as its diameter of 4 mm or less, shunt across foramen ovale, V max > 70 cm/sec along with a typical harsh sound during fetal ausculation during echocardiography and reversal flow in pulmonary veins, no extracardiac anomalies, singleton pregnancies and delivery > 37 weeks of gestation. It was retrospective analysis of 16 cases: There were 10 non-survivors and 6 survivors The only significant difference between survivors and non-survivors pertained to the fraction of newborns operated on up to 11th day, which was significantly higher among the survivors (5/6 vs. 2/8, p=0.031). Conclusions: 1) In the event of prenatal restriction of the foramen ovale early surgery by day 10 had a statistically better outcome in terms of survival compared to cases that underwent surgery at a later period at our Institute. 2) Prenatal restriction of the foramen ovale was more often related to male gender and in 75% of cases in our series had complicated follow-up: neonatal death or prolonged hospital stay.3) Information from prenatal echocardiography regarding restriction of the foramen ovale should be taken into consideration as valuable information suggesting priority for early cardiac surgery.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123991279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Respondek-Liberska, Ł. Sokołowski, M. Słodki, K. Zych-Krekora, I. Strzelecka, M. Krekora, I. Maroszyńska, J. Moll, J. Moll
Abstract Total anomalous pulmonary venous connection (TAPVC) is a congenital heart defect (CHD), in which all pulmonary veins connect to the systemic veins or to the right atrium/coronary sinus instead of the left atrium. We present a case report of fetus with prenatally diagnosed isolated infracardiac type of TAPVC in 38th week of gestation. In fetal echocardiographic examination performed in the Department of Prenatal Cardiology, the fetus presented lack of visible pulmonary veins connection to left atrium, abnormal venous confluence behind left atrium, additional vein leading from abdominal cavity to mediastinum and abnormal smooth Doppler blood flow in pulmonary confluence. The accurate prenatal diagnosis allowed to deliver the neonate at term, in tertiary center one day after diagnosis, and to perform surgical reposition of pulmonary veins the following day. The neonate was referred home in a good condition after 28 days of hospitalization. This case is a good example of the value of the 3rd trimester echocardiography.
{"title":"Prenatal Diagnosis of TAPVC on Monday, Delivery of Tuesday and Cardiac Surgery at Wednesday - A Model of Perinatal Care in 3rd Trimester in Case of Fetal/Neonatal Critical Heart Defect in Tertiary Center.","authors":"M. Respondek-Liberska, Ł. Sokołowski, M. Słodki, K. Zych-Krekora, I. Strzelecka, M. Krekora, I. Maroszyńska, J. Moll, J. Moll","doi":"10.1515/pcard-2016-0005","DOIUrl":"https://doi.org/10.1515/pcard-2016-0005","url":null,"abstract":"Abstract Total anomalous pulmonary venous connection (TAPVC) is a congenital heart defect (CHD), in which all pulmonary veins connect to the systemic veins or to the right atrium/coronary sinus instead of the left atrium. We present a case report of fetus with prenatally diagnosed isolated infracardiac type of TAPVC in 38th week of gestation. In fetal echocardiographic examination performed in the Department of Prenatal Cardiology, the fetus presented lack of visible pulmonary veins connection to left atrium, abnormal venous confluence behind left atrium, additional vein leading from abdominal cavity to mediastinum and abnormal smooth Doppler blood flow in pulmonary confluence. The accurate prenatal diagnosis allowed to deliver the neonate at term, in tertiary center one day after diagnosis, and to perform surgical reposition of pulmonary veins the following day. The neonate was referred home in a good condition after 28 days of hospitalization. This case is a good example of the value of the 3rd trimester echocardiography.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129650593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Leszczynska, K. Preis, M. Respondek-Liberska, M. Słodki, D. Wood, S. Weiner, U. Gembruch, G. Rizzo, R. Achiron, J. Pruetz, M. Sklansky, B. Cuneo, B. Arabin, I. Blickstein
Abstract Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton pregnancies but also in multiple pregnancies. Proper interpretation of prenatal echocardiography is critical to clinical decision making, family counseling and perinatal management for obstetricians, maternal fetal medicine specialists, neonatologists and pediatric cardiologists. Fetal echocardiography is one of the most challenging and time-consuming prenatal examinations to perform, especially in multiple gestations. Performing just the basic fetal exam in twin gestations may take an hour or more. Thus, it is not practical to perform this exam in all cases of multiple gestations. Therefore our review and recommendations are related to fetal echocardiography in twin gestation.
{"title":"Recommendations for Fetal Echocardiography in Twin Pregnancy in 2016","authors":"K. Leszczynska, K. Preis, M. Respondek-Liberska, M. Słodki, D. Wood, S. Weiner, U. Gembruch, G. Rizzo, R. Achiron, J. Pruetz, M. Sklansky, B. Cuneo, B. Arabin, I. Blickstein","doi":"10.1515/pcard-2016-0001","DOIUrl":"https://doi.org/10.1515/pcard-2016-0001","url":null,"abstract":"Abstract Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton pregnancies but also in multiple pregnancies. Proper interpretation of prenatal echocardiography is critical to clinical decision making, family counseling and perinatal management for obstetricians, maternal fetal medicine specialists, neonatologists and pediatric cardiologists. Fetal echocardiography is one of the most challenging and time-consuming prenatal examinations to perform, especially in multiple gestations. Performing just the basic fetal exam in twin gestations may take an hour or more. Thus, it is not practical to perform this exam in all cases of multiple gestations. Therefore our review and recommendations are related to fetal echocardiography in twin gestation.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127008061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Płużańska, J. Więcek, M. Krekora, Jolanta Kiełbasicz-Binikowska, T. Talar, M. Słodki, M. Respondek-Liberska
Abstract We present the case of aneurysm of the muscular intraventricular septum with accompanying cardiomegaly and abnormal venous flow patterns requiring emergency cesarean section and specialized neonatal treatment. At the age of 8 months our patient has no clinical symptoms with a 6 mm scar in intraventricular muscular septum..
{"title":"Emergency Cesarean Section in Case of Aneurysm of the Muscular Intraventricular Septum with Neonatal Follow-up - A Case Report and Review of the Literature","authors":"J. Płużańska, J. Więcek, M. Krekora, Jolanta Kiełbasicz-Binikowska, T. Talar, M. Słodki, M. Respondek-Liberska","doi":"10.1515/pcard-2016-0006","DOIUrl":"https://doi.org/10.1515/pcard-2016-0006","url":null,"abstract":"Abstract We present the case of aneurysm of the muscular intraventricular septum with accompanying cardiomegaly and abnormal venous flow patterns requiring emergency cesarean section and specialized neonatal treatment. At the age of 8 months our patient has no clinical symptoms with a 6 mm scar in intraventricular muscular septum..","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132325552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.5114/PCARD.2021.105966
M. Respondek-Liberska, M. Donofrio
{"title":"Maternal hyperoxygenation in prenatal ultrasound and fetal echocardiography – literature review 2020","authors":"M. Respondek-Liberska, M. Donofrio","doi":"10.5114/PCARD.2021.105966","DOIUrl":"https://doi.org/10.5114/PCARD.2021.105966","url":null,"abstract":"","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125582857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.5114/PCARD.2020.99686
Eduardo Félix Martins Santana, A. Moron, E. A. Júnior, M. Barbosa, Hérbene José Figuinha Milani, Stéphanno Gomes Pereira Sarmento, S. Cavalheiro
Material and methods: A study with 37 fetuses submitted to intrauterine myelomeningocele repair between the 24th and 27th week of gestation was performed to evaluate FHR at specific periods: pre-anaesthesia, post-anaesthesia, during neurosurgery (early skin manipulation, spinal cord release, and synthesis), and at the end of surgery. Surgery room (SRT) and uterine surface (UST) temperatures were strictly controlled. A plastic cover was used to protect to protect uterine heat loss. We determined the mean ± standard deviation (SD) of FHR of each period, and we used analysis of variance (ANOVA) with repeated measures to assess differences among these periods. Tukey multiple comparation test was used to compare global surgery stages. Results: The mean FHR in the specific time points were: 138.6, 138.4, 132.8, 127.7, 131.4, and 132.7 bpm, respec-tively ( p < 0.001). In the comparisons between times two by two, the neurosurgery stage presents the lower frequencies, especially during release of the spinal cord, but episodes of bradycardia were no longer found. SRT and UST remained stable during the critical stages of the procedure. Conclusions: It is known that many are the factors involved in fetal cardiovascular disorders. Possibly, these changes allowed for better haemodynamic control of the fetus, improving the safety of the procedure. is an important issue in order to understand the modifications that any intervention aimed to solve the blood transfusion can determine on the surviving fetuses. Many studies have shown that in the long term, after laser coagulation (LC) of severe TTTS syndrome, cardiac function and blood pressure return to normal in the majority of surviving twins. This indicates that the preceding cardiac dysfunction regresses once LC has removed the underlying cause. However, a reported increased in the prevalence of pulmonary stenosis despite successful LC justifies the need for prenatal and postnatal cardiac surveillance. Material and methods: In our data of 28 pairs of twins complicated by TTTS and undergoing LC, we observed abnormal prenatal cardiac findings before treatment and the postnatal occurrence of some structural heart defects. One twin recipient with hydrops and functional pulmonary atresia had the same features at postnatal follow-up; another twin recipient with fetal hydrops, and mitral and tricuspid valve regurgitation presented with moderate pulmonary stenosis postnatally. Results: One fifth of all TTTS recipient twins show congenital and/or acquired diseases, i.e. right ventricle outflow tract obstruction (RVOTO), PA, or PS. Laser coagulation in severe stages can solve the blood transfusion but does not solve the acquired CHD (such as right ventricular outflow obstruction and pulmonary valve atresia). Conclusions: Laser coagulation should always be performed before cardiac function deteriorates, if possible.
{"title":"Interventions to improve fetal heart rate patterns during open myelomeningocele repair","authors":"Eduardo Félix Martins Santana, A. Moron, E. A. Júnior, M. Barbosa, Hérbene José Figuinha Milani, Stéphanno Gomes Pereira Sarmento, S. Cavalheiro","doi":"10.5114/PCARD.2020.99686","DOIUrl":"https://doi.org/10.5114/PCARD.2020.99686","url":null,"abstract":"Material and methods: A study with 37 fetuses submitted to intrauterine myelomeningocele repair between the 24th and 27th week of gestation was performed to evaluate FHR at specific periods: pre-anaesthesia, post-anaesthesia, during neurosurgery (early skin manipulation, spinal cord release, and synthesis), and at the end of surgery. Surgery room (SRT) and uterine surface (UST) temperatures were strictly controlled. A plastic cover was used to protect to protect uterine heat loss. We determined the mean ± standard deviation (SD) of FHR of each period, and we used analysis of variance (ANOVA) with repeated measures to assess differences among these periods. Tukey multiple comparation test was used to compare global surgery stages. Results: The mean FHR in the specific time points were: 138.6, 138.4, 132.8, 127.7, 131.4, and 132.7 bpm, respec-tively ( p < 0.001). In the comparisons between times two by two, the neurosurgery stage presents the lower frequencies, especially during release of the spinal cord, but episodes of bradycardia were no longer found. SRT and UST remained stable during the critical stages of the procedure. Conclusions: It is known that many are the factors involved in fetal cardiovascular disorders. Possibly, these changes allowed for better haemodynamic control of the fetus, improving the safety of the procedure. is an important issue in order to understand the modifications that any intervention aimed to solve the blood transfusion can determine on the surviving fetuses. Many studies have shown that in the long term, after laser coagulation (LC) of severe TTTS syndrome, cardiac function and blood pressure return to normal in the majority of surviving twins. This indicates that the preceding cardiac dysfunction regresses once LC has removed the underlying cause. However, a reported increased in the prevalence of pulmonary stenosis despite successful LC justifies the need for prenatal and postnatal cardiac surveillance. Material and methods: In our data of 28 pairs of twins complicated by TTTS and undergoing LC, we observed abnormal prenatal cardiac findings before treatment and the postnatal occurrence of some structural heart defects. One twin recipient with hydrops and functional pulmonary atresia had the same features at postnatal follow-up; another twin recipient with fetal hydrops, and mitral and tricuspid valve regurgitation presented with moderate pulmonary stenosis postnatally. Results: One fifth of all TTTS recipient twins show congenital and/or acquired diseases, i.e. right ventricle outflow tract obstruction (RVOTO), PA, or PS. Laser coagulation in severe stages can solve the blood transfusion but does not solve the acquired CHD (such as right ventricular outflow obstruction and pulmonary valve atresia). Conclusions: Laser coagulation should always be performed before cardiac function deteriorates, if possible.","PeriodicalId":415760,"journal":{"name":"Prenatal Cardiology","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116635181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：