ABSTRACT
OBJECTIVE: Determine prenatal detection rate, mortality and association with genetic abnormalities in patients with severe CHD. METHOD: Single center retrospective study in patients with severe CHD diagnosed prenatally or postnatally (2006 to 2014). RESULTS: A total of 567 patients were included, 176 (31%) after prenatal diagnosis, with large differences in prenatal detection rate among CHD types. Coarctation (24%), tetralogy of Fallot (21%) and univentricular heart (19%) were the most prevalent CHD. Overall mortality rate was 30% with important contributions of prenatal mortality including termination of pregnancy (40%) and postnatal compassionate care (15%). In the group requiring surgery, mortality rate was 12%. Genetic testing was available in 70%. A genetic cause was present in 140/394 patients tested (36%; 25% in the total group). Mortality was higher in the group with abnormal genetic testing compared with those with normal or no genetic testing (57/141 vs 112/423; p = 0,002). CONCLUSION: Only one third of severe CHD are detected; overall mortality remains high (30%) with major contributions of termination of pregnancy and compassionate care. A genetic cause was found in 36% and was associated with a decreased survival. Counseling must include the possibility of associated genetic pathology and its impact on survival. © 2017 John Wiley & Sons, Ltd.
Subject(s)
Heart Defects, Congenital/diagnosis , Prenatal Diagnosis , Abortion, Induced , Belgium , Congenital Abnormalities/genetics , Female , Fetal Death/etiology , Fetal Diseases/diagnosis , Fetal Diseases/genetics , Heart Defects, Congenital/mortality , Heart Defects, Congenital/surgery , Humans , Infant, Newborn , Pregnancy , Prognosis , Retrospective Studies , Ultrasonography, PrenatalABSTRACT
We report a case of bilateral fetal hydrothorax presenting at 20â weeks of pregnancy, spontaneously resolving at 22â weeks and severely relapsing at 28â weeks in a fetus with normal karyotype. The cause was a high-output heart failure caused by vein of Galen malformation.
Subject(s)
Heart Failure/etiology , Hydrothorax/etiology , Intracranial Aneurysm/complications , Vein of Galen Malformations/complications , Adult , Female , Humans , Hydrops Fetalis/diagnostic imaging , Hydrops Fetalis/etiology , Hydrothorax/diagnostic imaging , Infant, Newborn , Intracranial Aneurysm/diagnostic imaging , Perinatal Death/etiology , Pregnancy , Recurrence , Ultrasonography, Prenatal , Vein of Galen Malformations/diagnostic imagingABSTRACT
BACKGROUND: Bladder exstrophy is a rare malformation. Prenatal diagnosis is usually an incidental finding on routine ultrasound examination. Triple-X syndrome (karyotype 47,XXX) is the most frequent sex chromosome aneuploidy in live-born females (approximately 1 in 1000). The diagnosis is often not made because women with 47,XXX karyotype have no or hardly any clinical symptoms during life. METHODS: Prenatal diagnosis of triple X karyotype is usually an incidental finding when an invasive prenatal diagnosis is performed for other reasons. RESULTS: Here, we report on two cases with bladder exstrophy and triple-X syndrome, one in a fetus and one in an adult. In view of two previous reports of this association in literature, causality of these two conditions should be considered. CONCLUSION: A gene dosage effect as possible underlying mechanisms will be discussed.
Subject(s)
Bladder Exstrophy/genetics , Epispadias/genetics , Gene Dosage/genetics , Sex Chromosome Disorders of Sex Development/genetics , Trisomy/genetics , Adult , Bladder Exstrophy/diagnostic imaging , Bladder Exstrophy/etiology , Chromosomes, Human, X/genetics , Epispadias/diagnostic imaging , Epispadias/etiology , Fatal Outcome , Female , Fetus , Humans , In Situ Hybridization, Fluorescence , Karyotyping , Sex Chromosome Aberrations , Sex Chromosome Disorders of Sex Development/complications , UltrasonographyABSTRACT
A male newborn with multiple cutaneous hemangiomatosis is described. Pregnancy was complicated by polyhydramnios and a large placental chorioangioma. After an initial outburst of the hemangiomas in the first two weeks of life, spontaneous and almost complete regression occurred before the age of 3 months. The relationship between hemangiomas and placental chorioangioma is briefly discussed.