Outcome for fetuses with prenatally detected congenital heart disease and cardiac arrhythmias in Taiwan.
OBJECTIVE
Outcome for fetuses with prenatally detected congenital heart disease (CHD) and/or cardiac arrhythmias is important for prenatal counseling and perinatal management; however, there exists little literature regarding the outcome for CHD diagnosed in utero in Taiwan. Therefore, we attempted to investigate the outcome for fetuses with CHD and/or cardiac arrhythmias diagnosed prenatally at a tertiary care medical center in Taiwan.


METHODS
Between January 1995 and December 2000, 339 patients referred to the National Taiwan University Hospital for fetal echocardiography were included in this study. Medical records were reviewed retrospectively to determine the salient clinical characteristics for all fetuses.


RESULTS
CHD was found in 103 fetuses. Gestational age at diagnosis ranged from 17 to 40 weeks; in 37 cases (35.9%) the diagnosis was made before 24 weeks. Mean gestational age at diagnosis was 27.8 weeks. Of the 103 cases, 15 fetuses (14.6%) had major extra cardiac malformations and 15 fetuses (14.6%) had chromosomal abnormalities (five had both) and 30 pregnancies (29.1%) were terminated. Of the remaining 73 pregnancies, three (4.1%) of the fetuses died in utero and 28 (38.4%) postnatally, with 42 (57.5%) surviving. The mortality rates were both 60% in cases with extracardiac or chromosomal anomalies. Arrhythmias were identified in 25, and two pregnancies involving hydrops fetalis were terminated. Of the remaining 23 continued pregnancies, two (8.7%) with long QT syndrome expired postnatally.


CONCLUSIONS
Outcome for fetuses with prenatally detected CHD remains poor, with the prognosis negatively influenced by the presence of complex heart defects as well as extracardiac and chromosomal anomalies. However, prognosis is good for fetuses with cardiac arrhythmia, except with long QT syndrome or hydrops fetalis.
Hsiao
Sheng-Mou
SM
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Wu
Mei-Hwan
MH
Jou
Hei-Jen
HJ
Lee
Chien-Nan
CN
Shyu
Ming-Kwang
MK
Shih
Jin-Chung
JC
Hsieh
Fon-Jou
FJ
D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000401:mortality; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D016216:Ultrasonography, Prenatal