Introduction:Congestive heart failure (CHF) in fetuses with congenital heart diseases is associated with high perinatal mortality. CHF may be assessed by the cardiovascular profile (CVP) score that comprises hydrops, cardiothoracic ratio, cardiac function, arterial and venous Doppler. Fetal right heart defects (critical pulmonary stenosis-7, pulmonary atresia with intact ventricular septum-18, and Ebstein's anomaly-3) were assessed. Our hypothesis was that outcome of these may be related to prenatal condition and LV function.
Objective:Our aim was to assess the value of CVP-score in evaluating risk of death in right heart defects diagnosed prenatally.
Methods:In a retrospective study, reviewed medical records of 28 fetuses, evaluated in our perinatal care center, between 2004-2008, with right heart defects. Correlation between death and the CVP-score, presence of RV-coronary fistula, Doppler and tissue Doppler parameters of LV performance was performed using chi-square tests for homogeneity and measures of association.
Results:There were 13 patients who died prior to 30-postnatal days-of-life. Statistical analyses of the data supports the hypothesis that the CVP-score is related to risk of death (p=0.04). The chi-square test also indicated a marginal statistical association between the presence of a fistula in a fetal echo and risk of death (p=0.08). LV parameters didn’t correlate with outcome.
Conclusions:Fetal echocardiography is useful in predicting outcome in right heart defects. There is an association between the CVP-scores assessed prenatally and the risk of fetal or neonatal death in this group. Further analyses will be performed to determine how the CVP-score could be weighted to more accurately predict the outcome.