Introduction: Congenital heart defects are the most frequent reason for deaths during the neonatal and early infancy periods. The aim of this study was to retrospectively analyze singleton pregnancy outcomes of premature neonates with congenital cardiac defects delivered by Cesarean section. Materials and methods: A retrospective analysis was performed on 10,800 fetuses evaluated in our referral fetal cardiac center between 2010 and 2016. A group of 58 singleton pregnancies was selected with the following criteria: fetal heart defect, Cesarean section (C-section), and gestation of 37 weeks or less. Exclusion criteria included labor outside of our hospital and multiple pregnancy. Results: Isolated heart defects constituted 74,1% (43 cases) of the analysed data set. The majority of newborns were delivered at 36 weeks of gestation (43,1%), with an average of 33,6 weeks. In one case (1,7%), C-section took place at 22nd week. Birth weight of newborns < 2500g constituted 51,7% (30 cases). Neonatal deaths occurred in 60,3% (35 cases). Conclusions: Preterm neonates with congenital heart defect, delivered by C-section in our reference centre, during 2010 to 2016, had generally poor outcomes and high mortality rate. The average hospital stay of surviving neonates was approximately two months. An improvement of knowledge about prenatal cardiology is necessary in obstetrician management with fetuses with congenital heart diseases.
1. Słodki M, Zych-Krekora K, Axt-Fliedner R, Bianchi A, Araujo E Jr, Blickstein I, Kelekci S, Yeo L, Pruetz JD, Rizzo G, Seligman N, Sklansky M, Catte L, Weiner S, Chervenak F, Cruz J, Kurkevych A, Krekora M, Respondek-Liberska M. The International Prenatal Cardiology
2. Collaboration Group - a new concept for global research study. J Ultrasonog. 2016; 16: 94-96.
3. Van Velzen CL, Türkeri F, Pajkrt E, Clur SA, Rijlaarsdam ME, Bax CJ, Hruda J, de Groot CJ, Blom NA, Haak MC. Pregnancy complications in singleton pregnancies with isolated fetal heart defects. Acta Obstet Gynecol Scand. 2016; 95: 1273-1280.
4. Nembhard WN, Salemi JL, Hauser KW, Kornosky JL. Are there ethnic disparities in risk of preterm birth among infants born with congenital heart defects? Birth Defects Res A Clin Mol Teratol. 2007; 79: 754-764.
5. Andrews RE, Simpson JM, Sharland GK, Sullivan ID, Yates RW. Outcome after preterm delivery of infants antenatally diagnosed with congenital heart disease. J Pediatr. 2006; 148: 213-216.
6. Miyoshi T, Katsuragi S, Neki R, Kurosaki KI, Shiraishi I, Nakai M, Nishimura K, Yoshimatsu J, Ikeda T. Cardiovascular profile score as a predictor of acute intrapartum non-reassuring fetal status in infants with congenital heart defects. J Matern Fetal Neonatal Med. 2016; 14: 1-7.
7. Story L, Pasupathy D, Sankaran S, Sharland G, Kyle P. Influence of birth weight on perinatal outcome in fetuses with antenatal diagnosis of congenital heart disease. J Obstet Gynaecol Res. 2015; 41: 896-903.
9. Changlani TD, Jose A, Sudhakar A, Rojal R, Kunjikutty R, Vaidyanathan B. Outcomes of infants with prenatally diagnosed congenital heart disease delivered in a tertiary-care pediatric cardiac facility. Indian Pediatr. 2015; 52: 852-856.
10. Strzelecka I, Płużanska J, Węgrzynowski J, Moszura T, Słodki M, Respondek-Liberska M. Routine third trimester fetal cardiac evaluation: time for consideration. Prenat Cardiol. 2015: 5: 18-23.
11. Słodki M, Respondek-Liberska M, Pruetz JD, Donofrio MT. Fetal cardiology: changing the definition of critical heart disease in the newborn. J Perinatol. 2016; 36: 575-580.
12. Słodki M. Habilitation Thesis. Medical University Lodz, PWSZ Plock: Poland,2012, https://www.researchgate.net/publication/291337775_Prenatal_and_perinatal_management_for_pregnant_women_with_fetal_cardiac_defects_based_on_new_prenatal_cardiac_anomalies_classification_Polish.