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Carvalho JS, Axt-Fliedner R, Chaoui R, Copel JA, Cuneo BF, Goff D, Gordin Kopylov L, Hecher K, Lee W, Moon-Grady AJ, Mousa HA, Munoz H, Paladini D, Prefumo F, Quarello E, Rychik J, Tutschek B, Wiechec M, Yagel S. ISUOG Practice Guidelines (updated): fetal cardiac screening. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:788-803. [PMID: 37267096 DOI: 10.1002/uog.26224] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 06/04/2023]
Affiliation(s)
- J S Carvalho
- Royal Brompton Hospital, Guy's & St Thomas' NHS Foundation Trust; and Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust and Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK
| | - R Axt-Fliedner
- Division of Prenatal Medicine & Fetal Therapy, Department of Obstetrics & Gynecology, Justus-Liebig-University Giessen, University Hospital Giessen & Marburg, Giessen, Germany
| | - R Chaoui
- Center of Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - J A Copel
- Departments of Obstetrics, Gynecology & Reproductive Sciences, and Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - B F Cuneo
- Children's Hospital Colorado, The Heart Institute, Aurora, CO, USA
| | - D Goff
- Pediatrix Cardiology of Houston and Loma Linda University School of Medicine, Houston, TX, USA
| | - L Gordin Kopylov
- Obstetrical Unit, Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A J Moon-Grady
- Clinical Pediatrics, UC San Francisco, San Francisco, CA, USA
| | - H A Mousa
- Fetal Medicine Unit, University of Leicester, Leicester, UK
| | - H Munoz
- Obstetrics and Gynecology, Universidad de Chile and Clinica Las Condes, Santiago, Chile
| | - D Paladini
- Fetal Medicine and Surgery Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - F Prefumo
- Obstetrics and Gynecology Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - E Quarello
- Image 2 Center, Obstetrics and Gynecologic Department, St Joseph Hospital, Marseille, France
| | - J Rychik
- Fetal Heart Program at Children's Hospital of Philadelphia, and Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA
| | - B Tutschek
- Pränatal Zürich, Zürich, Switzerland; and Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - M Wiechec
- Department of Gynecology and Obstetrics, Jagiellonian University in Krakow, Krakow, Poland
| | - S Yagel
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Mt. Scopus and the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Wakefield JC. The biostatistical theory versus the harmful dysfunction analysis, part 1: is part-dysfunction a sufficient condition for medical disorder? THE JOURNAL OF MEDICINE AND PHILOSOPHY 2014; 39:648-82. [PMID: 25336733 DOI: 10.1093/jmp/jhu038] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Christopher Boorse's biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield's harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze Boorse's central argument for the sufficiency claim, the "pathologist argument," which takes pathologists' intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion.
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Sarikouch S, Haas NA, Schaeffler R, Beerbaum P. Value of postmortem magnetic resonance imaging for fatal neonatal congenital heart disease: a case report. Pediatr Cardiol 2008; 29:667-9. [PMID: 18004614 DOI: 10.1007/s00246-007-9138-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2007] [Revised: 08/07/2007] [Accepted: 10/22/2007] [Indexed: 11/25/2022]
Abstract
Autopsies after neonatal death due to suspected or insufficient diagnosed cardiac malformations provide important information to parents and the involved obstetric and pediatric physicians. The autopsy rate, however, is declining. Postmortem magnetic resonance imaging may be an alternative option for selected cases, providing detailed morphologic information about the cardiovascular system. This case report demonstrates the beneficial use of postmortem magnetic resonance imaging in a newborn with a suspected complex cardiac malformation. The magnetic resonance imaging was able to complete the diagnosis of situs inversus totalis, with transposition of great arteries, and to provide valuable information about the underlying physiology.
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Affiliation(s)
- S Sarikouch
- Department of Congenital Heart Disease and Institute for Magnetic Resonance Imaging, Heart and Diabetes Center of Northrine Westfalia, Ruhr-University of Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany.
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Jeanty P, Chaoui R, Tihonenko I, Grochal F. A review of findings in fetal cardiac section drawings, part 1: The 4-chamber view. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:1601-1610. [PMID: 17957054 DOI: 10.7863/jum.2007.26.11.1601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES The goal of this presentation is to review some of the common and rare fetal heart abnormalities and to provide an easy approach to these findings with schematic drawings. METHODS Over the past 10 years, we collected cases in which the common views of the heart were abnormal and the differential diagnoses that existed for each. The presentation shows the normal sonographic sections and then variations of these sections and the associated anomalies. We used illustrative drawings to present these findings, enabling us to point out the main sonographic features of abnormalities of the heart. RESULTS The work reviews 17 fetal heart abnormalities in schematic drawings. CONCLUSIONS This short review highlights several of the anomalies that can be recognized on the common sonographic views. The drawings tend to simplify the findings but serve as a basis for those doing fetal echocardiography when they encounter an unusual finding.
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Affiliation(s)
- Philippe Jeanty
- Inner Vision Women's Ultrasound, 2201 Murphy Ave, Suite 203, Nashville, TN 37203, USA.
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Barsoum RS. Parasitic infections in transplant recipients. ACTA ACUST UNITED AC 2006; 2:490-503. [PMID: 16941042 DOI: 10.1038/ncpneph0255] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Accepted: 04/12/2006] [Indexed: 01/20/2023]
Abstract
Parasitic infections are important complications of organ transplantation that are often overlooked in the differential diagnosis of post-transplantation pyrexial illness. Although their frequency is unknown, they seem to be much less prevalent than bacterial and viral infections. Only 5% of human pathogenic parasites have been reported to cause significant illness in transplant recipients. Infection can occur via transmission with the graft or blood transfusion, or be acquired de novo from the environment. Recrudescence of dormant infection can lead to active disease. Post-transplantation parasitic disorders tend to cluster into two clinical profiles. First, an acute systemic illness with anemia, constitutional manifestations and variable stigmata of organ involvement; acute graft dysfunction can lead to confusion and acute rejection. Protozoa including malarial Plasmodium, Leishmania, Trypanosoma and Toxoplasma are associated with this profile. The second typical manifestation encompasses a few localized syndromes, usually associated with the lower gastrointestinal tract, caused by either protozoa (Cryptosporidium and microsporidia) or nematodes (Strongyloides and Ascaris). Dissemination of localized infections can lead to life-threatening systemic manifestations. A high index of suspicion is essential, as diagnosis requires special sampling techniques and laboratory procedures. Definitive diagnosis is usually achieved by detecting the parasite in the patient's tissues or body fluids by histological examination or culture, or by polymerase chain reaction amplification of the parasite-specific antigen sequence. Antibody detection using serological techniques is also possible in a few parasitic infections. Certain lesions have characteristic radiological appearances, hence the value of imaging, particularly in the cerebral syndromes. Treatment is usually straightforward (broad spectrum or specific drugs), yet some species are drug resistant.
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McEwing RL, Chaoui R. Congenitally corrected transposition of the great arteries: clues for prenatal diagnosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2004; 23:68-72. [PMID: 14971003 DOI: 10.1002/uog.896] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Congenitally corrected transposition of the great arteries (ccTGA) is an uncommon cardiac defect characterized by the atria connecting with the anatomically discordant ventricles and the ventricles connecting with discordant and transposed great arteries. Parallel vessels are evident in corrected TGA, but as this sign is also present in complete TGA, a heart anomaly requiring major cardiac surgery in the postnatal period, it is important to differentiate between the entities prenatally. Most cases of ccTGA have associated anomalies but isolated forms or those with a mild associated cardiac anomaly are infrequently detected prenatally. We report on three cases detected between 21 and 25 weeks' gestation on screening ultrasound with associated mild findings. One fetus had an isolated ventricular septal defect (VSD) first detected at 34 weeks. The child developed heart block at 4 years of age. The second case was associated with a small VSD, a tiny pulmonary trunk and a persistent right umbilical vein. After birth, mild pulmonary stenosis was found as an additional cardiac finding at 4 months of age. The third fetus had no additional cardiac anomalies prenatally, but after birth a bicuspid aortic valve was detected. The first case needed pacemaker implantation but the other two children required no cardiac surgery. Two of the cases were referred because abnormal vessel anatomy was detected on screening ultrasound. As prenatal detection of TGA is becoming a more frequent occurrence, this paper aims to present clues aiding in the prenatal diagnosis of atrioventricular and ventriculoarterial discordance, especially in its differentiation from complete transposition. These details are crucial for counseling and perinatal management.
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Affiliation(s)
- R L McEwing
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, Charité Hospital, CCM, Humboldt University, Berlin, Germany
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