[Fetal and genetic aspects of congenital heart disease]

Congenital fetal heart disease — course and outcome of pregnancies

The aim of the study was to analyze the course and outcome of pregnancies with congenital heart disease of the fetus, diagnosed and terminated at the Institute of gynecology and obstetrics Clinical Center of Serbia over four years.

The study included 71 patients, divided into 3 groups according to the fetal outcome. Group 1 had consisted of 9 pregnancies terminated artificially, Group 2 of 48 patients who delivered live fetuses, and Group 3 of 14 pregnancies terminated as fetal intrauterine death.

The types congenital heart diseases were categorized as follows: 40 had L-R shunting type, 18 R-L shunting type, 8 coartacion of aorta, and 7 valvular diseases. Intrauterine fetal death occurred in 11 pregnancies in Group 3 after 28 weeks of gestation. In 13 cases karyotypisation were done, because of maternal age or intrauterine growth retardation diagnosed with ultrasound, and 9 of them had genetic disorders. Forty-eight fetuses were born alive. Fourteen died in the first 2–7 days and 12 had successful heart surgery. Twenty-two needed no surgical correction. Ultrasound findings were false negative in 3 cases.

The diagnosis of fetal heart disease should be done by fetal echocardiogram, which can be preformed early in the beginning of the pregnancy.