1
|
Jadczak A, Respondek-Liberska M, Sokołowski Ł, Chrzanowski J, Rizzo G, Araujo Júnior E, Bravo-Valenzuela NJ, Axt-Fliedner R, Słodki M. Hypoplastic left heart syndrome with prenatally diagnosed foramen ovale restriction: diagnosis, management and outcome. J Matern Fetal Neonatal Med 2022; 35:291-298. [PMID: 31986935 DOI: 10.1080/14767058.2020.1716717] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Despite advances in prenatal diagnosis and postnatal intervention/surgery methods, patients with Hypoplastic Left Heart Syndrome (HLHS) and coexisting foramen oval restriction still achieve high mortality rates. Our objective was to determine survival predictors and to find answers to, why restriction develops in some, but not others. METHODS We performed a retrospective analysis of prenatal history and postnatal sequel of 22 patients with HLHS and foramen ovale restriction between 2008 and 2017. RESULTS There were 11 survivors and 11 nonsurvivors. The most significant difference between the two groups pertained to the average time of foramen ovale restriction diagnosis which was 33 weeks for survivors and 28 weeks for nonsurvivors (p = .0416) and the duration of in-utero restriction (9 versus 5 weeks, p = .0213). Twenty patients (20/22) exhibited possible signs of infection. CONCLUSIONS (1) Earlier development and longer presence of foramen ovale restriction in the setting of HLHS is associated with higher short-term mortality regardless of the degree of restriction. (2) Ratio of forward pulmonary vein flow to reverse flow (f/r) expressed as a velocity-time integral (VTI) is a good emergent intervention predictor, but it does not correlate with foramen ovale size and maximal velocity, nor does it influence survival rates. (3) Ultrasonographic signs of possible infection of the fetus is a potential risk factor of foramen ovale restriction development in patients with HLHS.
Collapse
Affiliation(s)
- Anna Jadczak
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lódz, Poland
| | - Maria Respondek-Liberska
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lódz, Poland
- Department of Diagnoses and Prevention of Fetal Malformations, Medical University of Lodz, Lódz, Poland
| | - Łukasz Sokołowski
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lódz, Poland
- Department of Obstetrics and Gynecology, Polish Mother's Memorial Hospital, Lódz, Poland
| | - Jędrzej Chrzanowski
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lódz, Poland
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lódz, Poland
| | - Giuseppe Rizzo
- Department of Maternal Fetal Medicine, Ospedale Cristo Re Roma, Università degli Studi di Roma "Tor Vergata", Rome, Italy
- Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Medical Course, Municipal University of São Caetano do Sul (USCS), São Paulo, Brazil
| | | | - Roland Axt-Fliedner
- Department of Obstetrics and Gynecology, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Maciej Słodki
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lódz, Poland
- Faculty of Health Sciences, The Mazovian State University in Plock, Poland
| | | |
Collapse
|
2
|
Czajkowski K, Helwich E, Preis K, Grzesiak M, Krekora M, Gulczyńska E, Kornacka K, Zeman K, Maroszyńska I, Respondek-Liberska M. Recommendations “Cardio-Prenatal 2017” From Poland. PRENATAL CARDIOLOGY 2018. [DOI: 10.1515/pcard-2018-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
On 27.10.2017, in the course of the CARDIO-PRENATAL Conference at the Polish Mother’s Memorial Institute and Health Centre in Lodz, we presented, among others, the following problems:
classification of prenatal heart defects, fetal hemodynamic status evaluation in the third trimester, expected neonate’s clinical condition, planned procedures to be conducted just after birth and also planned medical staff to be present in the delivery room. Here are our main recommendations following the meeting and discussion.
Collapse
Affiliation(s)
| | - Ewa Helwich
- National Consultant in Charge of Neonatology, Łódź , Poland
| | - Krzysztof Preis
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Gdańsk , Poland
| | - Mariusz Grzesiak
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Łódź , Poland
| | - Michał Krekora
- Deputy Head of the Clinics of Obstetrics & Gynaecology of the Polish Mother’s Memorial Hospital in Łódź , Poland
| | - Ewa Gulczyńska
- Provincial Consultant in Charge of Neonatology, Łódź , Poland
| | | | - Krzysztof Zeman
- Provincial Consultant in Charge of Immunology, Łódź , Poland
| | - Iwona Maroszyńska
- Chairwoman of the Łódź Branch of the Polish Society of Neonatology, Łódź , Poland
| | - Maria Respondek-Liberska
- President of Association for the Development of Prenatal Cardiology, Head of Prenatal Cardiology of the Polish Mother’s Memorial Hospital in Łódź, Head of Fetal Malformations Department, Medical University of Lodz , Poland
| |
Collapse
|