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Congenital heart disease pregnancy

Yi-Ling Huang, Kang-Hong Hsu, Enkhzaya Chuluunbaatar, Tzu-Ming Wen, Yi-Ying Li, Ming-Ren Chen, Chung-I Chang, Tung-Yao Chang
OBJECTIVE: To present an accurate prenatal diagnosis of coarctation of the aorta with ventricular septal defect and to illustrate how early diagnosis in prenatal period with proper referral and counseling can optimize management. CASE REPORT: A case with coarctation of the aorta with ventricle septal defect was found to have an abnormal three vessel view at 12 weeks, and with close follow-ups, coarctation of the aorta with ventricle septal defect was diagnosed at 24 weeks...
December 2018: Taiwanese Journal of Obstetrics & Gynecology
Clara Vázquez-Antona, Carlos Alva-Espinosa, Lucelli Yáñez-Gutierrez, Horacio Márquez-González
We present an update of the most relevant advances of three-dimensional echocardiography for the diagnosis of congenital heart diseases. The evolution of its treatment is analyzed, showing the results obtained in recent years. The functional and structural changes experienced in women with congenital heart disease during pregnancy are discussed, as well as the main health risks and the importance of teamwork in healthcare to treat these patients. Finally, we provide a review on the current situation in Mexico and outline some improvement recommendations...
2018: Gaceta Médica de México
Victoria M Fratto, Aileen Chang, Tracy Anton, Heather Y Sun, Leah M Lamale-Smith, Dolores H Pretorius
This study evaluates the impact of extended cardiac views on examination time, repeat imaging, and anomaly detection before and after implementation of 76811 guidelines (American Institute of Ultrasound in Medicine Consensus 2014). It is a retrospective study of singleton pregnancies undergoing detailed ultrasound imaging at 18 weeks' gestation or greater before and after the protocol change in an academic, tertiary care fetal center. Views required prior to 2014: 4-chamber, left outflow tract, right outflow tract...
December 3, 2018: Ultrasound Quarterly
Słodki Maciej, Soroka Małgorzata, Rizzo Giuseppe, Respondek-Liberska Maria
INTRODUCTION: Prenatal atrioventricular septal defect (AVSD) on frequent occasions coexists with other cardiac or extracardiac abnormalities or malformation which may change the prognosis and the management with the fetus and the newborn. The aim of the research was to assess the prognosis and the outcome of prenatally diagnosed AVSD based on the classification which also includes coexisting extracardiac abnormalities and malformations as well as its influence on the prenatal consultation...
December 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
Yu-Mi Im, Tae-Jin Yun, Il-Young Yoo, Sanghee Kim, Juhye Jin, Sue Kim
BACKGROUND: Prenatal diagnosis of fetal congenital heart disease (CHD) is becoming widely available but there is a lack of understanding on such expectant mothers' experiences during pregnancy. This was the first study to investigate the pregnancy experience of Korean mothers with a prenatal fetal diagnosis of CHD. METHODS: In-depth interviews were conducted with 12 mothers regarding their child's prenatal diagnosis of CHD and the adaptive processes during pregnancy...
December 3, 2018: BMC Pregnancy and Childbirth
Ching-Chun Huang, Bing-Yu Chen, Shih-Chun Pan, Yi-Lwun Ho, Yue Leon Guo
Gestational exposure to ambient air pollution has been associated with Congenital Heart Diseases (CHDs). However, only a few studies, with inconsistent results, have investigated the effects of PM2.5 exposure during early pregnancy. This study aims to evaluate the association between prenatal exposure to PM2.5 and CHDs occurrence. We selected 782 births reported to have CHDs between 2007 and 2014 from the Taiwanese Birth Registry and randomly selected 4692 controls without any birth defects using a population-based case-control design...
November 20, 2018: Science of the Total Environment
Yuan Zhang, Xia He, Xuan Xiong, Junlan Chuan, Lei Zhong, Guo Chen, Dongke Yu
Published studies indicate the MTHFR C677T and A1298C polymorphisms are associated with abnormal homocysteine levels, which may cause various pregnancy complications and birth defects. However, the results obtained from different studies have been inconsistent. Therefore, this meta-analysis explores the association between MTHFR polymorphisms and birth defects and adverse pregnancy outcomes. The Pubmed, ScienceDirect, Embase, China Biology Medicine literature databases and ClinicalTrials were searched. Analyses of public bias, meta-regression, subgroups, and sensitivity were used to ensure the robustness of our results...
November 25, 2018: Prenatal Diagnosis
Emily Mary O'Brien, David Law, David Celermajer, Peter Watson Grant, Jon Waites
OBJECTIVE: The number of adults with congenital heart disease has increased with improvements in surgical and medical management, posing a challenge for regional and rural settings, which might have difficulties accessing specialised professionals with congenital heart disease services. This study aims to ascertain the demographics and management of adults with congenital heart disease seen by a cardiology practice in regional Australia to better understand the needs of regional adults with congenital heart disease...
November 19, 2018: Australian Journal of Rural Health
M M Li, L Q Guo, S S Li, Q Zhang, D D Zhao, B Y Zhang, S N Dang, H Yan
Objective: To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns. Methods: A large cross-sectional survey was conducted between August and November 2013. A questionnaire survey was conducted among the childbearing aged women, selected through multistage stratified random sampling in Shaanxi from 2010 to 2013. All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes. Multivariable Poisson regression was conducted for data analyses...
October 10, 2018: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Elisa A Bradley, Anita Saraf, Wendy Book
Heart failure remains the most common cause of morbidity and mortality in adults with congenital heart disease (CHD). Although gender-specific outcomes are not robust, it seems that women with CHD may be more affected by late heart failure (HF) than men. A specialized and experienced adult CHD team is required to care for these women as they age, including assessment for reversible causes of HF and in the management of pregnancy, labor, and delivery.
January 2019: Heart Failure Clinics
Angela McBrien, Lisa K Hornberger
OBJECTIVES: To explore the technical aspects and clinical utility of early fetal echocardiography and screening of the fetal heart in early pregnancy. Also, to document differences in cardiac structure and function which can be demonstrated in the late first/early second trimesters. METHODS: In addition to summarizing our own experiences of late first/early second trimester fetal echocardiography, we reviewed the literature to explore clinical indications for, technical aspects, safety, accuracy, strengths and weaknesses of early fetal echocardiography...
November 14, 2018: Birth defects research
Diamond Ling, Jonathan G Dayan
Trisomy 21, or Down syndrome (DS), is a genetic disorder affecting approximately 1 in 500-750 live births. The prevalence of DS has increased over the past two decades, correlating with a rise in the proportion of pregnancies complicated by advanced maternal age. There is also a correlation between advanced maternal age and dizygotic twinning rates. There is an increased risk of at least one twin being affected in dizygotic pregnancies compared to singletons. However, despite this greater relative risk, reports of concordance of DS in both dizygotic twins are very rare...
2018: Case Reports in Pediatrics
Xiaoxia Li, Xianmei Huang, Hui Lu
RATIONALE: Neonatal lupus erythematosus (NLE) is an infrequent disease caused by transplacental maternal autoantibodies. The most common effects of NLE include cutaneous involvement and congenital heart block (CHB), although it might involve multiple organs, such as the liver, lungs, blood, and nervous or digestive systems. Izmirly PM1 and Tonello et al recently reported cutaneous manifestations of neonatal lupus and risk of subsequent CHB. The most serious complication of NLE is complete atrioventricular (AV) block...
November 2018: Medicine (Baltimore)
Robert M Rossi, Allison Divanovic, Emily A DeFranco
OBJECTIVE:  To characterize obstetric outcomes associated with cyanotic congenital heart disease (CCHD) in a contemporary population. STUDY DESIGN:  We conducted a population-based retrospective cohort study of all livebirths in Ohio (2006-2015). Obstetric characteristics of pregnancies complicated by fetal CCHD were compared with those without CCHD, excluding those with other anomalies and aneuploidy. The primary objective was to determine the risk of cesarean delivery among CCHD affected pregnancies...
October 29, 2018: American Journal of Perinatology
Michael Y Liu, Benjamin Zielonka, Brian S Snarr, Xuemei Zhang, J William Gaynor, Jack Rychik
Background Prenatal diagnosis of single ventricle-type congenital heart disease is associated with improved clinical courses. Prenatal counseling allows for optimal delivery preparations and opportunity for prenatal intervention. Expectant parents frequently ask what the likelihood of survival through staged palliation is and the factors that influence outcome. Our goal was specifically to quantify peri- and postnatal outcomes in this population. Methods and Results We identified all patients with a prenatal diagnosis of single ventricle-type congenital heart disease presenting between July 2004 and December 2011 at our institution...
October 2, 2018: Journal of the American Heart Association
Chih-Ping Chen, Shu-Yuan Chang, Chen-Ju Lin, Schu-Rern Chern, Peih-Shan Wu, Shin-Wen Chen, Shih-Ting Lai, Tzu-Yun Chuang, Wen-Lin Chen, Chien-Wen Yang, Wayseen Wang
OBJECTIVE: We present prenatal diagnosis of a familial 5p14.3-p14.1 deletion in a fetus with congenital heart disease on prenatal ultrasound. CASE REPORT: A 33-year-old woman underwent amniocentesis at 18 weeks of gestation because of fetal ventricular septal defect (VSD) and echogenic bowel on prenatal ultrasound. Amniocentesis revealed a karyotype of 46,XX,del (5) (p14p14). Simultaneous array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed a 5...
October 2018: Taiwanese Journal of Obstetrics & Gynecology
Anne S Siegmund, Marlies A M Kampman, Martijn A Oudijk, Barbara J M Mulder, Gertjan Tj Sieswerda, Steven V Koenen, Yoran M Hummel, Monique W M de Laat, Krystyna M Sollie-Szarynska, Henk Groen, Arie P J van Dijk, Dirk J van Veldhuisen, Caterina M Bilardo, Petronella G Pieper
OBJECTIVE: Pregnant women with congenital heart disease (CHD) have an increased chance of abnormal uteroplacental flow (UPF) measured from second trimester onwards. This is related to pregnancy complications affecting mother and baby. Maternal right ventricular (RV) dysfunction has been suggested as predisposing factor. First trimester UPF screening, followed by therapeutic strategies, is effective in preventing pregnancy complications. The study aim was to relate first trimester UPF measurements to pre-pregnancy maternal cardiac function and pregnancy complications...
October 17, 2018: Ultrasound in Obstetrics & Gynecology
Anne-Sophie Sillesen, Anna Axelsson Raja, Christian Pihl, Ruth Ottilia Birgitta Vøgg, Morten Hedegaard, Pernille Emmersen, Karin Sundberg, Ann Tabor, Cathrine Vedel, Helle Zingenberg, Charlotte Kruse, Charlotte Wilken-Jensen, Tina Holm Nielsen, Finn Stener Jørgensen, Dorthe Lisbeth Jeppesen, Lars Søndergaard, Pia R Kamstrup, Børge G Nordestgaard, Ruth Frikke-Schmidt, Niels Vejlstrup, Heather A Boyd, Henning Bundgaard, Kasper Iversen
Congenital heart diseases (CHDs) are reported in 0.8% of newborns. Numerous factors influence cardiovascular development and CHD prevalence, and possibly also development of cardiovascular disease later in life. However, known factors explain the probable etiology in only a fraction of patients. Past large-scale population-based studies have made invaluable contributions to the understanding of cardiac disease, but none recruited participants prenatally and focused on the neonatal period. The Copenhagen Baby Heart Study (CBHS) is a population-based study of the prevalence, spectrum, and prognosis of structural and functional cardiac abnormalities...
October 10, 2018: European Journal of Epidemiology
Charlène Bredy, François-Pierre Mongeon, Line Leduc, Annie Dore, Paul Khairy
Atrial septal defect (ASD) is the most common form of congenital heart disease. Left-to-right shunting leads to right ventricular (RV) volume overload with excessive pulmonary blood flow. Complications include exercise intolerance, pulmonary vascular disease, RV dysfunction, paradoxical thromboemboli, and atrial arrhythmias. Women with coexisting severe pulmonary hypertension should be counselled against pregnancy due to high incidence of maternal and fetal morbidity and mortality. In the absence of pulmonary hypertension, pregnancy is generally well tolerated in the setting of an ASD...
September 2018: Journal of Thoracic Disease
Diana S Wolfe, Afshan B Hameed, Cynthia C Taub, Ali N Zaidi, Anna E Bortnick
Cardiac disease in pregnancy is the number one indirect cause of maternal mortality in the United States. We propose a triad solution that includes universal screening for cardiovascular disease in pregnancy and postpartum women, patient education, and institution of a multidisciplinary cardiac team. Additionally, we emphasize essential elements to maximize care for the pregnant cardiac patient based on our experience at our institution in Bronx, NY.
September 29, 2018: American Journal of Obstetrics and Gynecology
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