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. 2010:2010:628451.
doi: 10.1155/2010/628451. Epub 2010 Oct 3.

Features and outcomes in utero and after birth of fetuses with myocardial disease

Vlasta Fesslova  1 , Maurizio Mongiovì, Salvatore Pipitone, Jelena Brankovic, Laura Villa
Affiliations

Features and outcomes in utero and after birth of fetuses with myocardial disease

Vlasta Fesslova et al. Int J Pediatr. 2010.

Abstract

Objectives. Ninety-one fetuses with dilated or hypertrophic cardiomyopathy (DCM, HCM) and myocarditis were studied. Results. Group 1 "DCM" included 19 fetuses: 13 with hydrops (FH) and 5 with associated extracardiac anomalies (ECAs) (15.8%). Group 2 "Myocarditis" included twelve fetuses, having 11 with FH. Group 3 "HCM" included sixty fetuses: 26 had associated ECAs, 17 had maternal diabetes, and 17 were "idiopathic"; however, in one case, a metabolic disorder was found postnatally, and 4 had familiarity for HCM. Outcomes. Ten cases opted for termination of pregnancy. Two cases with DCM and 1 with HCM were lost at follow-up. Out of the cases that continued pregnancy, with known follow-up, mortality was 68.75% in Group 1, 63.6% in Group 2, and 31.3% in Group 3 (the majority with severe ECAs). Surviving cases with DCM and myocarditis improved, 2 with HCM worsened, 6 remained stable, and 26 improved or normalized. Conclusions. Our data show more severe prognosis in DCM and myocarditis and forms with severe associated ECAs.

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Figures

Figure 1
Figure 1
(a) Echocardiography of a fetus with endocardial fibroelastosis—a high echodensity of the left ventricular (LV) walls due to calcifications is evident. RV—right ventricle, A—aorta. (b) Fetus with myocarditis and fetal hydrops: both ventricles and atria are dilated and the arrows indicate the pericardial effusion. RV—right ventricle, LV—left ventricle.
Figure 2
Figure 2
Doppler findings in fetuses with DCM and fetal hydrops: (a) The tracing of the tricuspid valve (T) shows a reduced systolic A-wave, with respect to the diastolic E-wave; (b) holosystolic tricuspid regurgitation (ITr); (c) a reverse systolic flow of the inferior vena cava (small arrow); (d) a reverse systolic flow of ductus venosus (small arrow); (e) the fluctuation of the umbilical vein.
Figure 3
Figure 3
Flow chart summarizing the frequency and the outcomes in the different forms of myocardial disease.
Figure 4
Figure 4
(a) Fetus with hypertrophic cardiomyopathy in 2-D; (b) M-mode recording showing hypertrophy of the left ventricular walls, with a small cavity and mitral valve movement with diastolic apposition and anterior systolic motion. RV—right ventricle, LV—left ventricle, M—mitral valve.
See this image and copyright information in PMC

References

    1. Maron BJ, Towbin JA, Thiene G, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. 2006;113(14):1807–1816. - PubMed
    1. Rowe RD, Freedom RM, Mehrizi A, Bloom KR. Cardiomyopathies. 2nd edition. chapter 23. Philapdelphia, Pa, USA: Saunders WB & Co.; 1081. The neonate with congenital heart disease; p. 397.
    1. Maron BJ, Robert WC. Cardiomyopathies in the first two decades of life. In: Engle MA, editor. Pediatric Cardiovascular Disease. Philadelphia, Pa, USA: Davis FA; 1981. p. 35. - PubMed
    1. Fesslova V, Bellotti M, Pirozzi I. Myocardial disease in utero: features and outcome in 24 cases. Journal of Maternal & Fetal Investigation. 1993;3:249–254.
    1. Fesslova V, Nava S, Villa L. Evolution and long term outcome in cases with fetal diagnosis of congenital heart disease: Italian multicentre study. Heart. 1999;82(5):594–599. - PMC - PubMed

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