Agnieszka Nawara-Baran and Beata Radzymińska-Chruściel
The aim of this study was an analysis of cardiac assessment in the first trimester, their outcomes, and comparison with literature data. Five cases were analysed from the year 2014. The exams were performed between 11-13 + 6 weeks. The analysis confirmed that the detection of CHD in 1 st trimester was possible and was verified by an early fetal echocardiogram. The most common symptoms of abnormal heart images in the early screening assessment were: axis, heart size and color Doppler assessment of the chambers and V sign. The outcome of pregnancies with early detection of fetal heart defects was poor. There was only one surviver
Agnieszka Nawara, Beata Radzymińska-Chruściel, Maria Respondek Liberska, Katarzyna Januszewska and Edward Malec
Absent of pulmonary valve syndrome is a rare congenital heart defect, which is diagnosed prenataly in 0,8% of fetuses with congenital heart defect based on the data from National Polish Registry Of Fetal Cardiac Anomalies.
We present a case of pregnat woman and fetus with that heart defect, which was detected in the 1st trimester and treated prenatally with digoxin, amnioreduction, tocolysis and steroids following by the cardiac sugery in the neonatal period. Despite an intensive therapy, the infant died on the 3rd month of age.
We belive that the main reason of poor outcome was premature delivery at the 35th week of gestation.
We present unique cardiac images proving the changing characterists of this type anomay since 1 st trimester
Maciej Słodki, Joanna Szymkiewicz-Dangel, Agata Włoch, Aldona Siwińska, Beata Radzymińska-Chruściel and Maria Respondek-Liberska
The Polish National Registry for Fetal Cardiac Pathology, which has been in existence since 2004, is one of the unique organisational achievements of the Polish prenatal cardiology. Now that the calendar year 2012 is over, we are setting about working on the summary of our work to chart its new directions.
Materials and methods:
Standard data reports from the year 2012 have been analysed and compared with data published in the Prenatal Cardiology quarterly in 2011 and other data collected between 2004 and 2010.
538 new records were entered in the Registry in 2012. Consequently, the total number of examinations registered between 2004 and 2012 amounts to 5297 records. 72% (n = 388) of all the patients entered in the Registry were examined by C-type centres, i.e. Warsaw (186), Łódź (150) and Ruda Śląska (79). The commonest heart defects included hypoplastic left heart syndrome (n = 81), tetralogy of Fallot (n = 51) and AVSD (n = 49): atrial & ventricular components (n = 49). The data collected between 2004 and 2010, in 2011 and 2012 were compared. In 2011 544 foetuses with cardiologic problems were registered, while in 2012 there were 538 of them. In 2011, there were 24 centres in the Registry. Last year, there were 27 of them. As in the previous years, HLHS was the most frequently registered foetus heart defect in 2012. In 2012 the second one was TOF. In 2012, LSF and PBU were the two major prenatal cardiology centres in Poland and registered over 100 foetuses every year. In 2012, the number of doctors diagnosing over five cases of foetal heart defects a year reached 10%. The majority of the doctors (89%) diagnosed such cases rarely (< 5 cases a year). In 2011, the percentage of the pregnant women who decided to terminate the pregnancy was larger than between 2004 and 2010, but smaller than in 2012; it was < 7%.
The data included in the 2012 in The Polish National Registry for Fetal Cardiac Pathology is similar to the data collected in the previous years. The classification of foetal heart defects is imperfect and interpreted in various ways by particular centres. This needs to be changed in the future; the way the classification is interpreted must be made uniform.
Beata Radzymińska-Chruściel, Urszula Dajda, Sebastian Zalewski, Anna Piatkowska, Julia Wieczor, Dariusz Gołąbek, Daniel Porada and Andrzej Rudzinski
This is case report of extremely rare mosaic trisomy of 16th pair of chromosomes from the high risk pregnancy (maternal age 35 years old, positive screeining in 1st trimester). The fetus presented with intrauterine growth retardation, congenital heart defect, dysmorphic features and skeletal anomalies. The case has been observed until hospitalization in pediatric cardiology department. Other similar cases have been analysed.
Paulina Kordjalik, Beata Radzymińska-Chruściel, Maciej Słodki, Agata Włoch, Joanna Szymkiewicz-Dangel, Maria Respondek-Liberska and Zdzisław Tobota
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.