[Fetal cardiac tumors]. / Tumores cardíacos fetales.

INTRODUCTION AND OBJECTIVES: Fetal cardiac tumors are rare and have a different histology than in adults: in the fetus, rhabdomyoma is more prevalent, but myxoma has not been described. We report our experience with nine fetuses with prenatally diagnosed primary cardiac tumours. METHODS: This is an observational and descriptive study of fetuses investigated because of the prenatal and echographic diagnosis of heart tumors. RESULTS: There were nine fetuses with thirteen cardiac masses among more than 700 fetal echocardiographic studies performed by pediatric cardiologists. Histology was available in four of them; three rhabdomyomas and once cavernous hemangioma. In one of the cases, the parents elected to interrupt the pregnancy; three patients died in the neonatal period (two as a direct consequence of the tumors and one due to sepsis) and we have no histological information regarding any of the other five fetuses. The subjects who survived beyond the neonatal period are mostly doing well. However, one developed tuberous sclerosis and another developed a hypoplastic left heart syndrome, perhaps due to the massive restriction of flow across the foramen ovale. The tumors in the other cases were well tolerated and hemodynamic or arrhythmic consequences were minimal of absent. No women with risk factors such as tuberous sclerosis were included in our study. CONCLUSIONS: Fetal cardiac tumors are rare and display a different histology. We recommend a conservative approach to treatment.

La ecografía en el control de la gestante diabética / Ultrasound for the follow up of the pregnant diabetic

Se estudia la utilidad de la ecografía en el control de 144 gestantes diabéticas desde un triple sentido: Control del crecimiento del feto, diagnóstico prenatal de malformaciones congénitas y diagnóstico del grado de bienestar fetal. En el diagnóstico prenatal de recién nacidos grandes para su edad gestacional los ultrasonidos diagnosticaron correctamente 23 de 30 casos (76.6%), con un índice de falsos negativos del 7%. En los casos de crecimiento intrauterino retardado la ecografía detectó los 4 casos existentes (100%), con un índice de falsos positivos de 33.3%, sin que existieran falsos negativos. Todos los casos de malformaciones congénitas mayores correspondientes a microcefalia, mielomeningocele occipital, nipoplasia de colon izquierdo y síndrome de Meckel-Gruber (disencefalia esplacno-quística), fueron diagnósticados prenatalmente mediante ultrasonidos