Ebstein’s Anomaly of the Tricuspid Valve in the Fetus – A Multicenter Experience
| Autor: | Christoph Berg, Ulrike Herberg, Renate Oberhoffer, Brigitte Strizek, Annegret Geipel, Arne Willruth, Rüdiger Stressig, Ulrich Gembruch, Lea Gottschalk, J. Ritgen, Ingo Gottschalk, Johannes Breuer |
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| Rok vydání: | 2016 |
| Předmět: |
Pediatrics
medicine.medical_specialty 030204 cardiovascular system & hematology 03 medical and health sciences Fetus 0302 clinical medicine Pregnancy Germany Prenatal Diagnosis Ebstein's anomaly Hydrops fetalis medicine Humans Radiology Nuclear Medicine and imaging Child Retrospective Studies 030219 obstetrics & reproductive medicine Tricuspid valve business.industry Gestational age medicine.disease Ebstein Anomaly medicine.anatomical_structure Pulmonary valve Female Tricuspid Valve business Loss rate |
| Zdroj: | Ultraschall in der Medizin - European Journal of Ultrasound. 38:427-436 |
| ISSN: | 1438-8782 0172-4614 |
| DOI: | 10.1055/s-0042-107151 |
| Popis: | Purpose To assess the spectrum of associated anomalies, the intrauterine course, the outcome and possible prognostic markers in prenatally diagnosed Ebstein’s anomaly (EA). Materials and Methods All cases of EA diagnosed over a period of 13 years with a minimum follow-up of 1 year were retrospectively collected in 4 tertiary referral centers in Germany. Results In the study period 76 cases of EA were prenatally diagnosed. The mean gestational age at diagnosis was 25.0 weeks (range: 13 – 35). 41 (53.9 %) cases were isolated and 35 (46.1 %) had other cardiac and/or extracardiac anomalies. 19 (25.0 %) pregnant women opted for termination of pregnancy, intrauterine fetal death occurred in 7 cases (9.2 %), neonatal death in 14 cases (18.4 %), death in infancy or childhood in 9 cases (11.8 %) and 27 children (35.5 %) were alive at the last follow-up. After exclusion of terminations, the only parameter inversely correlated with intrauterine survival was hydrops fetalis. Prognostic parameters significantly associated with postnatal non-survival were an abnormal Celermajer index (right atrium/heart ratio > 0.7), cardiomegaly (cardiothoracic circumference ratio > 0.5), absence of antegrade flow over the pulmonary valve and earlier diagnosis in pregnancy. Conclusion Prenatally diagnosed EA has a high morbidity and mortality with the highest loss rate in the intrauterine and neonatal period. In our study, hydrops fetalis was the only parameter significantly associated with intrauterine demise, while other prenatal markers were only significantly associated with postnatal mortality. |
| Databáze: | OpenAIRE |
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