Diagnoses and prognoses of fetal cardiovascular anomalies in utero, assessed echocardiographically.

Abstract

AbstractThis echocardiographic study was designed to determine the accuracy of prenatal diagnoses of fetuses with cardiac anomalies and also to evaluate the manner in which various types of disorders affect the prognoses in utero. In 13 fetuses studied, the following cardiac anomalies were present: ventricular septal defect (VSD), atrial septal defect (ASD), atrio‐ventricular septal defect (AVSD), double outlet of the right ventricle, hypoplastic right (HPRV) and left (HPLV) ventricles, Ebstein's anomaly, endocardial fibroelastosis (EFE), transposition of the great arteries, coarctation of the aorta and cardiac tumor.These were categorized by the minimum unit of cardiovascular anomalies. According to this criteria, the correct, false positive, false negative, and misinterpretations were estimated to be 71.4, 4.8, 14.3 and 9.5%, respectively. After division of correctly diagnosed cases into 2 groups, 86.7% of heart anomalies and 50.0% of those of great vessels were found to be accurately diagnosed.Fetal prognoses with cardiovascular anomalies were classified into 3 groups: cardiac failure, intrauterine growth retardation and no sequelae.The first group was representative of EFE and HPRV, the second group, representative of hypoplastic ventricle and deffective heart diseases complicated by chromosome anomalies or other major malformations. The third group included all anomalies but with no sequelae in utero.