[Prognosis of atrioventricular canal in euploid foetus without abnormality of atrial situs].
Atrioventricular septal defects are commonly diagnosed during fetal life. Postnatal prognosis of atrioventricular septal defects associated with trisomy 21 and with heterotaxia sequences are relatively well known. However, predicting postnatal outcome in fetus with atrioventricular septal defects and normal chromosome and normal atrial situs remains a challenge. In a series of 141 fetal atrioventricular septal defects, we analyzed 80 fetuses with normal karyotype. Twenty-seven had an abnormal atrial situs. One fetus was lost for follow-up. Finally, 52 fetuses were included in the study. Termination of pregnancy was performed in 18 cases (34%). Six fetuses died in utero (18% of ongoing pregnancies). Twenty eight infants were born alive, 2 of them were lost for follow-up right after birth and 3 live born infants died postanatally (11%). Postoperative mortality was 3/15 (20%). Complete repair was proceed for 13 infants, palliative repair for 2; and 8 infants didn't have surgery at the end of follow-up because of partial or intermediate atrioventricular septal defect. The only factor significantly associated with poor outcome was the small size of the left ventricle. Isolated atrioventricular septal defects are of poor cardiac prognosis particularly when associated with left heart obstructions.
Maltret
A
A
Centre de référence "Malformations cardiaques Congénitales Complexes-M3C", Université Paris-V, Necker-Enfants Malades, AP-HP, Paris.
Moura
C
C
Le Bidois
J
J
Fermont
L
L
Bajolle
F
F
Stos
B
B
Azancot
A
A
Bonnet
D
D
D000028:Abortion, Induced; D002423:Cause of Death; D004452:Echocardiography; D004694:Endocardial Cushion Defects / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006325:Heart Atria / Q000002:abnormalities; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007621:Karyotyping; D010166:Palliative Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014694:Ventricular Outflow Obstruction / Q000209:etiology