Prenatal diagnosis by echocardiogram and outcome of absent pulmonary valve syndrome.
We reported echocardiographic findings and outcomes of fetuses with absent pulmonary valve syndrome diagnosed during fetal life. Cases were identified from a prospectively acquired computerized database of 18,308 pregnancies referred to a fetal cardiology center between January 1988 and July 2000. Twenty fetuses were identified with a median gestation of 23 weeks (range 18 to 36) at presentation. In 18 cases (90%), there was an associated ventricular septal defect. Eighteen cases (90%) had branch pulmonary artery diameters above the normal range. In four cases (20%), an arterial duct was present. A chromosome 22q11 deletion was identified in 2 of 9 cases (22%) in which this deletion was sought. There were 6 terminations of pregnancy (30%), 3 intrauterine deaths (15%), 5 neonatal deaths (25%), 3 infant deaths (15%), and 3 patients who did not die (15%). Ten of the 11 "liveborn" infants required early ventilation. The outcome of absent pulmonary valve syndrome diagnosed prenatally appears poor. The high morbidity and mortality is due to both cardiac disease and associated bronchomalacia.
Razavi
Reza S
RS
Fetal Cardiology Unit, Department of Congenital Heart Disease, Guy's Hospital, London, United Kingdom.
Sharland
Gurleen K
GK
Simpson
John M
JM
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D000032:Abortion, Therapeutic; D002872:Chromosome Deletion; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005865:Gestational Age; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D006801:Humans; D007223:Infant; D015931:Intensive Care, Neonatal; D007621:Karyotyping; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D012121:Respiration, Artificial; D016019:Survival Analysis; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods*