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Manandhar SR, Ghimire A, Rai D, Shrestha S, Adhikari P. Hypoplastic Left Heart Syndrome: A Case Report. JNMA J Nepal Med Assoc 2023; 61:665-667. [PMID: 38289811 PMCID: PMC10566614 DOI: 10.31729/jnma.8243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Indexed: 02/01/2024] Open
Abstract
Hypoplastic left heart syndrome is a rare critical congenital heart defect constituting a prevalence of 1/3,500 to 1/12,500 live births in which there is obstructions to the blood flow within the left heart. Here we present a case of a full-term 38 weeks male baby with a birth weight of 3.5 kg, and no obvious physical deformity referred to our centre at 22 hours of life for respiratory distress and cyanosis. At 23 hours of life, he was diagnosed with hypoplastic left heart syndrome and kept on Prostaglandin E1 infusion till the 12th day of life. The baby had a large ventricular septal defect and atrial septal defect with a severely hypoplastic left ventricle, hypoplastic aortic root, ascending aorta and post-ductal coarctation of the aorta. The diagnosis was reconfirmed by computed tomography cardiac angiography on the 10th day of life with the same cardiac findings suggestive of hypoplastic left heart syndrome. Keywords case reports; congenital heart disease; hypoplastic left heart syndrome.
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Affiliation(s)
- Sunil Raja Manandhar
- Neonatology Unit, Department of Paediatrics, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Anjila Ghimire
- Neonatology Unit, Department of Paediatrics, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Dipendra Rai
- Neonatology Unit, Department of Paediatrics, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Sabina Shrestha
- Neonatology Unit, Department of Paediatrics, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Pritha Adhikari
- Neonatology Unit, Department of Paediatrics, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
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Karuga FF, Szmyd B, Petroniec K, Walter A, Pawełczyk A, Sochal M, Białasiewicz P, Strzelecki D, Respondek-Liberska M, Tadros-Zins M, Gabryelska A. The Causes and Role of Antinatalism in Poland in the Context of Climate Change, Obstetric Care, and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13575. [PMID: 36294154 PMCID: PMC9602747 DOI: 10.3390/ijerph192013575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Antinatalism is an umbrella term for numerous moral dilemmas associated with procreation. In the past few years, the deterioration of environmental conditions, social difficulties, global worsening of people's mental health, and pandemics have induced discussion about antinatalism. Therefore, we aimed to characterize antinatalists in the Polish population in terms of the frequency and description of the main reasons behind this phenomenon. The cross-sectional study was performed in the Polish population. An online, four-part survey was performed between 19 and 25 January 2022. The study group comprised 1240 respondents. Antinatalists (n = 472, 38%) were defined as people who do not have children and want to be childless in the future, whereas pronatalists (n = 768, 62%) consisted of people who want to have offspring in the future and/or already have children. The opinion that climate change is a significant reason not to have a child appeared twice as often among antinatalists. Additionally, the performed binary logistic regression model highlighted the importance of the fear of climate change as an independent factor facilitating an antinatalistic attitude. Regarding females, the following factors discouraging them from having a child were observed: fear of child's congenital diseases, pregnancy complications, dissatisfaction with medical services, and fear of exacerbation of maternal chronic diseases. Anxiety, depression, and stress were not found to be statistically different between pro- and antinatalist groups. However, further analysis revealed that female antinatalists were significantly more depressive and anxious. Our study helps us to understand why, as mentioned beforehand, around 38% of respondents prefer to stay childless. In conclusion, antinatalism views have become relatively prevalent in society, and its reasons include environmental antinatalism and medical factors, including depression and anxiety. However, better access to medical services and changes in climate politics were not found to be significant factors in encouraging society to decide to have offspring.
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Affiliation(s)
- Filip Franciszek Karuga
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Bartosz Szmyd
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery, Medical University of Lodz, 90-549 Lodz, Poland
- Department of Pediatrics, Oncology, and Hematology, Medical University of Lodz, 91-738 Lodz, Poland
| | | | | | - Agnieszka Pawełczyk
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery, Medical University of Lodz, 90-549 Lodz, Poland
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
| | - Maria Respondek-Liberska
- Department for Diagnoses and Prevention, Medical University of Lodz, 93-338 Lodz, Poland
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital, 93-338 Lodz, Poland
| | - Monika Tadros-Zins
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital, 93-338 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
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Fesslova V, Cavoretto PI. Recent Advances in the Diagnosis and Management of Congenital Heart Defects. J Clin Med 2022; 11:jcm11195534. [PMID: 36233399 PMCID: PMC9570749 DOI: 10.3390/jcm11195534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Vlasta Fesslova
- Center of Fetal Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy
| | - Paolo Ivo Cavoretto
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, University Vita-Salute, Via Olgettina 60, 20132 Milan, Italy
- Correspondence:
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The Left Ventricular Myocardium in Hypoplastic Left Heart Syndrome. J Cardiovasc Dev Dis 2022; 9:jcdd9080279. [PMID: 36005443 PMCID: PMC9409828 DOI: 10.3390/jcdd9080279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
Hypoplastic left heart syndrome (HLHS) is a collective term applied to severe congenital cardiac malformations, characterised by a combination of abnormalities mainly affecting the left ventricle, associated valves, and ascending aorta. Although in clinical practice HLHS is usually sub-categorised based on the patency of the mitral and aortic (left-sided) valves, it is also possible to comprehensively categorise HLHS into defined sub-groups based on the left ventricular morphology. Here, we discuss the published human-based studies of the ventricular myocardium in HLHS, evaluating whether the available evidence is in keeping with this ventricular morphology concept. Specifically, we highlight results from histological studies, indicating that the appearance of cardiomyocytes can be different based on the sub-group of HLHS. In addition, we discuss the histological appearances of endocardial fibroelastosis (EFE), which is a common feature of one specific sub-group of HLHS. Lastly, we suggest investigations that should ideally be undertaken using HLHS myocardial tissues at early stages of HLHS development to identify biological pathways and aid the understanding of HLHS aetiology.
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The Value of Fetal Heart Evaluation in Fetuses with Rare Congenital Lymphangiomas: A Cohort Study from a Single Tertiary Center across Two Decades (Years 1999-2020). J Clin Med 2022; 11:jcm11041035. [PMID: 35207307 PMCID: PMC8874571 DOI: 10.3390/jcm11041035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022] Open
Abstract
Lymphangiomas are uncommon, benign (from a histopathology viewpoint) malformations of the lymphatic system with thin-walled vessels; however, these tumors may be dangerous for fetal or neonatal life. They are observed in 1:6000 newborns at birth and in 1:750 spontaneous abortions. We aimed to investigate the role of fetal echocardiography in the prognosis of lymphangioma. Selected data of 19,836 pregnant women studied between 1999 and 2020 were retrospectively analyzed. In total, 32 cases of lymphangioma meeting the following criteria were further analyzed: (1) ultrasound availability from the 1st trimester of pregnancy and (2) nuchal translucency ≤ 2.5 mm. Echocardiographic findings, karyotype, size, and location of the possible lesion were juxtaposed with the clinical follow-up. The statistical analysis was performed using Statistica 13.1 software (StatSoft, Tulsa, OK, USA). Lymphangioma in the analyzed material coexisted with abnormalities in fetal echo in 78% (n = 25) of cases, especially: heart defect in 50% (n = 16) and with normal heart structure with functional changes in 28% (n = 9). Karyotype was available in 50% of the analyzed cases (n = 16). Normal cytogenetic results were observed in 62.5% (n = 10) of cases. In the remaining cases, the following were observed: Turner Syndrome: 25% (n = 4) and Down Syndrome 12.5% (n = 2). The rate of alive newborns was significantly higher among fetuses with isolated lymphangioma in comparison to those with lymphangioma associated with abnormal ECHO examination: 38.46% (n = 5) vs. 15.38% (n = 2; p = 0.037). Abnormal ECHO exam was a poor prognostic sign for fetuses with lymphangioma; therefore, we think it is important to refer these cases for detailed echocardiography in tertiary centers. Moreover, it should be highlighted that in all lymphangioma cases there was an indication to perform the karyotype assessment, as there was a high risk of aneuploidy.
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