Abstract
Objective. To assess the frequency of prenatal detection and the structure of extracardiac pathology (ECP) potentially complicating the course of the neonatal period by ultrasound examination of fetuses with congenital heart defects (CHD).
Material and methods. 436 pregnant patients with fetal CHD were examined at the gestational age of 16-40 weeks at the Perinatal Cardiological Center of the Bakoulev National Medical Research Center of Cardiovascular Surgery and National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov in 2018–2021.
Results. ECP was detected in 77 (17.7%) cases, including genitourinary system anomalies in 35 (8.0%) fetuses, gastrointestinal tract anomalies in 24 (5.5%) fetuses, facial structures anomalies in 10 (2.3%) fetuses, facial anomalies in 2 (0.5%) fetuses, and multisystem lesions in 6 (1.4%) fetuses. The rate of ECP depending on the type of CHD was: 94.1% (16/17) in heterotaxic syndromes, 29.0% (9/31) in atrioventricular septal defect, 25% (2/8) in common arterial trunk, 22.2% (12/54) in tetralogy of Fallot and 22.2% (4/18) in double outlet right ventricle, 21.4% (3/14) in univentricular heart, 16.7% (2/12) in stenosis / atresia of the tricuspid valve, 14.3% (1/7) in the aortic stenosis, 13% (3/23) in the pulmonary valve anomalies, 11.7% (4/34) in non-obstructive and 9.5% (10/105) in obstructive aortic arch lesions, 7.7% (2/26) in hypoplastic left heart syndrome, 6.6% (1/15) in tricuspid dysplasia / Ebstein's anomaly, 5.8% (3/52) in transposition of the great arteries cases. Also, a high frequency ECP was determined in fetuses with venous return anomalies (4/4 of cases).
Conclusion. Cases with fetal CHD are at increased risk for the presence of ECP that can potentially complicate the course of the neonatal period. It is necessary to conduct a detailed examination of the organs and structures of the fetus as soon as possible after the diagnosis of CHD is established for the earliest possible formation of a high-risk group of cases with unfavorable perinatal outcomes and for correct and timely routing of the patient.
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About the authors
- Tamara A. Yarygina, Cand. Med. Sci., Ultrasonic Diagnostician; ORCID
- Rena M. Gasanova, Dr. Med. Sci., Сardiologist, Ultrasonic Diagnostician; ORCID
- Elena I. Leonova, Ultrasonic Diagnostician; ORCID
- Ol’ga V. Marzoeva, Cand. Med. Sci., Ultrasonic Diagnostician, Researcher; ORCID
- Elena V. Sypchenko, Cand. Med. Sci., Ultrasonic Diagnostician; ORCID
- Aleksandr I. Gus, Dr. Med. Sci., Professor, Chief Researcher; ORCID
