title: Changed outcomes of fetuses with congenital heart disease: new Italian Multicentre study.
abstract: OBJECTIVE
  To analyse the outcomes of fetuses with congenital heart disease between 2000 and 2005 in comparison to a previous multicentre study regarding the period 1983-1996.
  
  
  METHODS
  Data of seven centres were prospectively collected, the inclusion criteria being a confirmed fetal diagnosis after birth or at autopsy and a known follow-up, for at least 6 months after birth. Data of 649 fetuses, median age at diagnosis 24 weeks' gestation (15-37), 340/649 (52.4%) diagnosed before 24 weeks, were analysed.
  
  
  RESULTS
  Sixty seven and 59 cases had chromosomal or extracardiac anomalies (10.3 and 9.1%). Termination of pregnancy was chosen in 21.6% of cases versus 28.9% in the previous study, being significantly lower in cases with early diagnosis (P <0.001). Out of 509 fetuses continuing pregnancy, 23 died in utero (4.5%) and 110 (21.1%) postnatally, versus 43% in the previous study (P <0.0017). Total surgical/postprocedure death occurred in 20.6% (59/287 infants) versus 37% previously (P <0.003), 67 infants being premature and 35 with associated chromosomal or extracardiac anomalies. The current overall mortality rate was higher in cases with chromosomal or extracardiac anomalies (59.5 and 51.35%, respectively, whereas it was 20.1% in isolated congenital heart disease). Overall current survival was 376 of 509 (73.9%) versus 45% in the previous study (P <0.0001).
  
  
  CONCLUSIONS
  Our data show a reduced overall and surgical mortality, with respect to our previous study, resulting from resulting from an improved perinatal management and treatment of affected fetuses in the more recent era.
authors.affiliation: aCenter of Fetal Cardiology, Policlinico San Donato IRCSS, Milan bDepartment of Obstetrics and Gynecology, Ospedale Civile di Legnano, Legnano cDepartment of Pediatric Cardiology and Obstetrics and Gynecology, Policlinico S. Orsola IRCCS, Bologna dDepartment of Pediatric Cardiology and Obstetrics and Gynecology, Sapienza University of Rome, Rome eDepartment of Cardiology, Azienda Ospedaliera Bolzano, Bolzano fDepartment of Pediatric Cardiology, Ospedale Ferrarotto, Azienda Vittorio Emanuele, Catania gDepartment of Pediatrics, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Vlasta
authors.initials: V
authors.lastname: Fesslova'
authors.forename: Jelena
authors.initials: J
authors.lastname: Brankovic
authors.forename: Chiara
authors.initials: C
authors.lastname: Boschetto
authors.forename: Annaclaudia
authors.initials: A
authors.lastname: Masini
authors.forename: Daniela
authors.initials: D
authors.lastname: Prandstraller
authors.forename: Antonella
authors.initials: A
authors.lastname: Perolo
authors.forename: Flavia
authors.initials: F
authors.lastname: Ventriglia
authors.forename: Silvia
authors.initials: S
authors.lastname: Macerola
authors.forename: Roberto
authors.initials: R
authors.lastname: Crepaz
authors.forename: Cristina
authors.initials: C
authors.lastname: Romeo
authors.forename: Francesco
authors.initials: F
authors.lastname: De Luca
authors.forename: Agata
authors.initials: A
authors.lastname: Previtera
authors.forename: Gabriella
authors.initials: G
authors.lastname: Errico
mesh_terms: D005260:Female; D046689:Fetal Mortality / Q000639:trends*; D005333:Fetus / Q000002:abnormalities*; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007558:Italy; D018743:Perinatal Care / Q000639:trends; D054238:Perinatal Mortality / Q000639:trends*; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal