title: Prenatal and Postnatal Survival of Fetal Tetralogy of Fallot: A Meta-analysis of Perinatal Outcomes and Associated Genetic Disorders.
abstract: OBJECTIVE
  The aim of this systematic review was to compare the postnatal outcomes, genetic testing results, and sonographic findings in 3 subtypes of tetralogy of Fallot.
  
  
  METHODS
  Thirty-six articles from the MEDLINE and EMBASE databases were selected for this review. The postnatal outcomes, karyotyping results, and sonographic findings of fetal tetralogy of Fallot with pulmonary stenosis, tetralogy of Fallot with pulmonary atresia, and tetralogy of Fallot with an absent pulmonary valve were collected and compared.
  
  
  RESULTS
  The survival rates (termination of pregnancy was considered fetal death) for prenatally diagnosed tetralogy of Fallot with pulmonary atresia and tetralogy of Fallot with an absent pulmonary valve at the end of neonatal period were significantly lower than the rate for tetralogy of Fallot with pulmonary stenosis (P < .05). The survival rate for tetralogy of Fallot with pulmonary atresia was also lower at birth (P < .001). Major chromosomal anomalies were more frequently detected in tetralogy of Fallot with pulmonary stenosis (P< .05); conversely, 22q11 deletion was present more often in fetuses with tetralogy of Fallot with pulmonary atresia and tetralogy of Fallot with an absent pulmonary valve (P < .001). Compared to tetralogy of Fallot with pulmonary stenosis, a right aortic arch was more associated with tetralogy of Fallot with pulmonary atresia (32.6%; P < .05), and the ductus arteriosus was almost always absent in tetralogy of Fallot with an absent pulmonary valve (87.5%; P < .001).
  
  
  CONCLUSIONS
  The postnatal outcomes, genetic testing results, and sonographic findings are different among subtypes of tetralogy of Fallot. Documenting those details at diagnosis can help specialists better counsel their patients.
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia USA xiangyayili@hotmail.com.
authors.forename: Yili
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: Alfred
authors.initials: A
authors.lastname: Abuhamad
authors.affiliation: Department of Pediatric Cardiology, Children's Hospital of the King's Daughters, Norfolk, Virginia USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fleenor
authors.affiliation: Department of Ultrasound, Shengjing Hospital, China Medical University, Shenyang, China.
authors.forename: Yajun
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Biological Sciences, Molecular and Computational Biology Program, University of Southern California, Los Angeles, California USA.
authors.forename: Wangshu
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Danming
authors.initials: D
authors.lastname: Cao
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Zeng
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, Virginia USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Sinkovskaya
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Qichang
authors.initials: Q
authors.lastname: Zhou
mesh_terms: D005260:Female; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D016019:Survival Analysis; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: absent ductus arteriosus; chromosomal anomaly; fetal echocardiography; fetus; right aortic arch; tetralogy of Fallot