Journal of the Formosan Medical Association
Volume 106, Issue 6 , Pages 423-431, 2007

Outcome for Fetuses with Prenatally Detected Congenital Heart Disease and Cardiac Arrhythmias in Taiwan

  • Sheng-Mou Hsiao

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Mei-Hwan Wu

      Affiliations

    • Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Hei-Jen Jou

      Affiliations

    • Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan
    • ,
  • Chien-Nan Lee

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Ming-Kwang Shyu

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Jin-Chung Shih

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Fon-Jou Hsieh

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Professor Fon-Jou Hsieh, Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 1 November 2006; received in revised form 11 December 2006; accepted 13 March 2007.

Article Outline

Background/purpose

Outcome for fetuses with prenatally detected congenital heart disease (CHD) and/or cardiac arrhythmias is important for prenatal counseling and perinatal management; however, there exists little literature regarding the outcome for CHD diagnosed in utero in Taiwan. Therefore, we attempted to investigate the outcome for fetuses with CHD and/or cardiac arrhythmias diagnosed prenatally at a tertiary care medical center in Taiwan.

Methods

Between January 1995 and December 2000, 339 patients referred to the National Taiwan University Hospital for fetal echocardiography were included in this study. Medical records were reviewed retrospectively to determine the salient clinical characteristics for all fetuses.

Results

CHD was found in 103 fetuses. Gestational age at diagnosis ranged from 17 to 40 weeks; in 37 cases (35.9%) the diagnosis was made before 24 weeks. Mean gestational age at diagnosis was 27.8 weeks. Of the 103 cases, 15 fetuses (14.6%) had major extra cardiac malformations and 15 fetuses (14.6%) had chromosomal abnormalities (five had both) and 30 pregnancies (29.1%) were terminated. Of the remaining 73 pregnancies, three (4.1%) of the fetuses died in utero and 28 (38.4%) postnatally, with 42 (57.5%) surviving. The mortality rates were both 60% in cases with extracardiac or chromosomal anomalies. Arrhythmias were identified in 25, and two pregnancies involving hydrops fetalis were terminated. Of the remaining 23 continued pregnancies, two (8.7%) with long QT syndrome expired postnatally.

Conclusion

Outcome for fetuses with prenatally detected CHD remains poor, with the prognosis negatively influenced by the presence of complex heart defects as well as extracardiac and chromosomal anomalies. However, prognosis is good for fetuses with cardiac arrhythmia, except with long QT syndrome or hydrops fetalis.

Key Words:  arrhythmia , congenital heart disease , echocardiography , prenatal diagnosis

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PII: S0929-6646(09)60291-6

doi:10.1016/S0929-6646(09)60291-6

Journal of the Formosan Medical Association
Volume 106, Issue 6 , Pages 423-431, 2007

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