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Open access

Małgorzata Sabatowska, Małgorzata Soroka and Maciej Słodki

Abstract

Congenitally corrected transposition of great arteries is a rare congenital heart defect. The clue of the abnormality is the inversion of the ventricles which caused abnormal atrioventricular and ventriculoarterial connections. This defect is seldom identified prenatally, much more seldom than the simple transposition of the great arteries, even though, we can observe it, on the image of 4 chambers of the heart. Prenatal diagnosis of this defect, at the 24th week of pregnancy and during the routine ultrasound scan, is being described below. The echocardiographical features of the congenitally corrected transposition of great arteries are being presented, with reference to the differences in the image of the 4 chamber view.

Open access

Paulina Kordjalik, Beata Radzymińska-Chruściel, Maciej Słodki, Agata Włoch, Joanna Szymkiewicz-Dangel, Maria Respondek-Liberska and Zdzisław Tobota

Abstract

As in every year since 2004, we analyzed data from the Polish National Registry for Fetal Cardiac Pathology to follow actual trends in types of congenital heart disease (CHD) and to assess the development of prenatal cardiology in Poland. Overall, the most frequent cardiac malformation detected prenatally in 2013 -2014, similar to the previous years, was hypoplastic left heart syndrome (HLHS). The average age of the examined fetuses was unchanged and remained above 20 weeks of gestation. An increased trend of detecting other cardiac malformations, such as transposition of the great arteries (d-TGA) and aortic stenosis (AS), and the predominance of vaginal deliveries over cesarean deliveries suggested significant improvements in prenatal and perinatal care in Poland.

Open access

Maria Respondek-Liberska

Abstract

An example of missed Down syndrome with congenital heart defect by prenatal ultrasound evaluation was presented. A jury of 12 physicians, experts in prenatal ultrasonography and echocardiography were asked in questionare was this malpractice or not.

The answers were very different. The results of the questionaires were discussed with the background to the selected data from Eurocat, from Polish National Prenatal Cardiac Registry, from Polish Registry of Congenital Malformations by 2nd year of life, and financial data of the Polish Prenatal Program in Lodz Region.

Should we increase the cost of screening or the cost of ultrasound and echo training ? Or just provide patients with better knowledge regarding the differences between expertise of primary care obstetricians and experts in referral centers

Open access

Magdalena Mazurak

Abstract

In the history of civilization twins always fascinated, but initially they were treated as a freak of nature. Relatively recently the first scientific attempts were made to elaborate this theme and in the 50s of the 20th century the first national register of twins was created (Danish). Currently, there are many of such databases and they are an excellent source for a various analyzes, including the incidence and risk factors of genetically determined diseases, among others congenital heart defects. This paper presents a historical, sociological and medical aspects connected with the fascinating world of twins.

Open access

Katarzyna Więckowska, Lech Dudarewicz, Hanna Moczulska, Maciej Słodki, Zbigniew Pietrzak and Maria Respondek-Liberska

Abstract

The primary aim of this study was to determine the predictive value of prenatal ultrasound and echocardiography for prognosis in congenital heart disease (CHD) with coexisting diaphragmatic hernia (DH) in a tertiary care center. Eleven records from the database of the Department for Diagnoses and Prevention of Congenital Malformations, Polish Mother’s Memorial Hospital Research Institute, were reviewed. The mean maternal age was 29,2 ± 5,1 years, and the mean gestational age at the time of diagnosis was 28,4 ± 6,7 weeks. No information was available for children discharged from hospital. Data of eight cases of prenatal DH and complex heart disease from the literature were also analyzed. Three fetuses survived the neonatal period. In each of these, CHD was other than the urgent or critical type, defined as not requiring cardiac surgical intervention in the first day or month of life. Both sets of data collected from our center and the published literature confirmed the unfavorable prognosis for fetuses with severe or critical CHD with coexisting DH.

Open access

Agnieszka Nawara-Baran, Karl Frontzek, Herbert Budka and Paweł P. Liberski

Abstract

A case of the rare fetal brain tumor is presented. This initally was observed as bleeding and ventriculomegaly and it was diagnosed at 28th week gestation by 2D, 3D and TUI ultrasound. The patient remained under the perinatal care until the end of pregnancy: cesarean section was performed at 37th week of gestation. Despite neurosurgery, the baby died on the 3rd day of postnatal life. On the basis of histopathological examination the diagnosis was established such as highly malignant tumor with focal ependymal and neuronal differentation that expands the current histopathology tumors classification.

Open access

Paula Wildner and Maria Respondek-Liberska

Abstract

11 deletion syndrome, Jacobsen syndrome (JBS), is a rare genetic abnormality associated with a wide variety of phenotypes. There are only a few case reports of JBS diagnosed prenatally, however majority resulting in termination of pregnancy. We present for the first time a prenatal diagnosis of JBS with congenital heart defect common arterial trunk type I (CAT) and the changing phenotype during fetal and postnatal life.

Open access

Paulo Zielinsky

Abstract

Fetal ductal constriction is a potentially severe functional alteration, often causing right ventricular overload and insufficiency, tricuspid regurgitation and neonatal pulmonary hypertension. Classically, maternal administration of indomethacin and/or other nonsteroidal antiinflammatory drugs interfere in prostaglandin metabolism, leading to ductal constriction. However, many cases of fetal ductal constriction, as well as of persistent neonatal pulmonary artery hypertension, remain without an established etiology, being referred as “idiopathic”. In recent years, a growing body of evidences has shown that herbs, fruits, nuts, and a wide diversity of substances commonly used in daily diet, because of their high content of polyphenols, have definitive effects upon the metabolic pathway of inflammation, with consequent inhibition of prostaglandins synthesis. This anti-inflammatory action of polyphenols, when ingested during the third trimester of pregnancy, may interfere with the dynamics of fetal ductus arteriosus flow and cause ductal constriction. This review has the purpose to approach these new evidences, which may influence dietary orientation during pregnancy.

Open access

Aleksandra Świercz, Sylwia Lewandowska, Krzysztof Szaflik, Adam Oleś, Anna Piaseczna-Piotrowska and Maria Respondek Liberska

Abstract

Shunt implantation in utero being a life-saving procedure, may be connected with a wide range of complications. One of them is catheter dislocation, a side effect which may impair the state of the fetus and child. We present a case of a boy with Congenital Adenomatoid Lung Malformation (CALM) type II. Invasive prenatal therapy, complicated by shunt migration did not influence our patient’s health. Moreover, the abnormally located shunt stayed within the child’s chest up to the age of 6 years. No symptoms linked to foreign body presence were observed. Although similar cases were published, we report a situation, in which the catheter was left in the patient’s body for 6 years, for the first time.

Open access

Birgit Arabin

Abstract

The incidence of twin gestation has increased over the past decades and contributes to an increased rate of spontaneous preterm birth and increased mortality and morbidity up to adult age. Prevention of spontaneous preterm birth in twin pregnancies differs from interventions in singleton pregnancies.

Up to now, many treatment modalities have been investigated such as bed rest, tocolytics, antibiotics, cerclage or progestagens, but have failed to prevent prematurity rates in twin gestations or were even combined with harmful effects. Cervical pessaries might be a non-invasive cost-effective option, but it is mandatory to evaluate vaginal progesterone and cervical pessaries in twin gestations with a short cervix in further randomized trials.