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Echocardiographic Methods of Fetal Heart Size Assessmentheart to Chest Area Ratio and Transversal Heart Diameter

Abstract

Introduction: Ultrasound assessment of fetal heart size (FHS) is widely used and recommended in many guidelines of fetal echocardiography due to its clinical value. The aim of this study was an analysis of some fetal heart measurements: ratio of heart area to chest area (HA/ CA) and transversal diameter of heart (AP) and their correlation to gestational age.

Material and methods: This retrospective study was based on database of records of ultrasound and echocardiographic examinations performed in our unit and included fetuses between 15th and 39th week of gestation with no evidence of heart defect or any abnormality.

Results: 609 ultrasound examinations were analyzed. The mean HA/CA was 0,30 ± 0,015, with no statistical difference between female and male (p>0,05), and seemed to be relatively constant with slight increase with advancing gestational age. The AP diameter in whole group correlated with gestational age (r=0,94) and there was no difference related to the fetuses gender.

Conclusion: The correlation of AP diameter and relative constancy of HA/CA ratio with gestational age presented in our normograms could be used for monitoring fetal development, but also for fetal cardiomegaly assessment.

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An Outline of Cardiogenesis

: Cambridge University Press; 2004.O. 4. Hutson MR, Kirby ML (2003). Neural crest and cardiovascular development: a 20-year perspective. Birth Defects Res C Embryo Today 69:2-13 5. Copel JA, Cullen M, Green JJ, et al. The frequency of aneuploidy in prenatally diagnosed congenital heart disease: an indication for fetal karyotyping. Am J Obstet Gynecol 1988; 158:409. 6. Srivastava D (2006). Making or breaking the heart: from lineage determination to morphogenesis. Cell 126: 1037-1048. 7. Lindsay EA, Vitelli F, Su

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Fetal Thymus - Review

References 1. Yeager SB, Sanders SP. Echocardiographic identification of thymic tissue in neonates with congenital heart disease. Am Heart J 1995; 129: 837-9. 2. Felker RE, Cartier MS, Emerson DS, Brown DL. Ultrasound of the fetal thymus. J Ultrasound Med 1989; 8: 669-673. 3. Zalel Y, Gamzu R, Mashiach S, Achiron R. The development of the fetal thymus: an in utero sonographic evaluation. Prenat Diagn. 2002 Feb;22(2):114-7. 4. Machlitt A, Tennstedt C, Körner H, Bommer C, Chaoui R. Prenatal

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Relative Certainty as Opposed to Uncertainty in the Diagnosis of Isomerism

, Wilkinson JL, Anderson RH.: Univentricular heart of right ventricular type with double or common inlet. Circulation 1979, 59: 403‑411 10. Bamforth SD, Bragança J, Farthing CR, Schneider JE, Broadbent C, Michell AC, Clarke K, Neubauer S, Norris D, Brown NA, Anderson RH, Bhattacharya S.: Controls left-right patterning and heart development through a Nodal-Pitx2c pathway. Nat Genet 2004, 36: 1189-1196 11. Meno C, Shimono A, Saijoh Y, Yashiro K, Mochida K, Ohishi S, Noji S, Kondoh S, Hamada H.: Lefty-1 is required for left-right determination

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HLHS on the basis of a Nationwide Registry of Fetal Cardiac Pathology www.orpkp.pl

Abstract

Congenital anomalies of development are an important issue in terms of both medical and social problems. In Poland in the years 2004-2012, an increase of detection of congenital heart defects in the form of HLHS (in 2004 - 22 fetuses, in 2006 - 38 fetuses, in 2008 - 66 fetuses, in 2010 - 69, in 2012 - 79 fetuses was observed). In 2012, the Nationwide Registry of Fetal Cardiac Pathology in the form of heart defect HLHS occupied first place among the most frequently detected heart defects, 10.2% of all registered patients with heart defects.

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Prenatal invasive decompression therapy of an arachnoid cyst in a fetus with normal heart anatomy and no functional anomalies - a case report

Abstract

We present a case of a female fetus with large posterior fossa cyst. After detailed diagnosis in referral center revealing normal heart anatomy and no functional abnormalities in cardiovascular system, a trial decompression of the fluid reservoir was suggested to the parents and successfully performed at the 30th week of pregnancy. Neurosurgical treatment was continued in the neonatal period. At the age of 7 months, the child presented normal physical development, and the cranial image of the CNS showed good recovery of the brain.

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Routine third trimester fetal cardiac evaluation: time for consideration

Abstract

Most heart defects form between 4 and 6 weeks after fertilization. The detection rate is still growing. Despite significant progress in prenatal diagnosis some cases still go undetected. We present two cases of similar defects: prenatally detected and undetected, both presenting with a normal four chamber view in mid-pregnancy. We compared the follow-up of both neonates along with sustained health and economic consequences. The dynamics of the development of heart defects during prenatal life suggests the legitimacy to perform additional, late echocardiography exams (35-38 weeks of gestation)

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Hydrops Fetalis and Congenital Pulmonary Capillary Haemangiomatosis in a Premature Infant - A Case Report and Literature Review

Abstract

Pulmonary capillary haemangiomatosis (PCH) is a rare disorder of the lung, well described in adult literature. PCH is characterized by capillary proliferation, infiltrating the interstitium and alveolar walls. This leads to development of respiratory distress and to end-stage pulmonary hypertension. Mostly young adults are affected. The affection of newborn is described in less than ten cases in literature in the past forty years. PCH is a mostly deadly ending disease. We present a preterm born infant with antepartal diagnosed hydrops fetalis, who died 30 minutes after birth. Autopsy revealed PCH as lethal reason and not cardial disease as presumed before.

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The Polish National Registry for Fetal Cardiac Pathology (www.Orpkp.Pl) – Selected Data Analysis for 2013 and 2014 and Comparison wth Data from 2004 to 2012

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.

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Extraordinary Bulging Mass in the Foetus - A Case Report of Bladder Exstrophy

Abstract

INTRODUCTION: Prenatal diagnosis of bladder exstrophy is extremley rare and difficult. BACKGROUND: Due to abnormal development of the cloacal membrane there is an incomplete closure of the lower abdominal wall, absence of the anterior wall of the bladder and external exposition of the posterior wall. The pubic bones are usually separated, the umbilical cord low inserted and there is abnormal external genitalia development. CASE REPORT: At 21st week of gestation of 39-year-old multigravida multipara referred by a primary care obstetrician to high-specialised centre for a detailed ultrasound examination with a suspicion of bladder absence and inferior umbilical localisation. At 29 weeks of gestation presence of bulging mass of 2 cm, between the umbilical outlet and labia was detected. At 31 weeks of gestation previously detected structure among thighs had 3 cm diameter with lateral umbilical outlet. Major labia were prominent and minor labia were within normal limits. Between two umbilical arteries with an appropriate intraabdominal course there were no transsonic area corresponding to the urinary bladder. The newborn baby was born at term in a good condition, but with an exposed bladder of 4 cm in diameter. The urethral outlet was not visualised and the female genitals were abnormal. After a month the girl underwent primary bladder exstrophy closure. Although she suffers from recurring urinary tract infections, she is in a good general condition. CONCLUSIONS: Due to prenatal diagnostics it was possible to detect and make an initial diagnosis of severe malformation. Early diagnosis allowed to prepare parents for a newborn with a defect and teach them how to take care of the baby.

Open access