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Vol. 30, No. 4, 2011
Issue release date: December 2011
Section title: Original Paper
Fetal Diagn Ther 2011;30:280–288
(DOI:10.1159/000330762)

Echocardiographic Risk Stratification of Fetuses with Sacrococcygeal Teratoma and Twin-Reversed Arterial Perfusion

Byrne F.A. · Lee H. · Kipps A.K. · Brook M.M. · Moon-Grady A.J.
aDivision of Cardiology, Department of Pediatrics, University of California San Francisco Benioff Children’s Hospital, bDepartment of Surgery, Pediatric Heart Center, cFetal Treatment Center, and dDivision of Pediatric Surgery, Department of Surgery, University of California San Francisco, San Francisco, Calif., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 2/17/2011 7:47:13 PM
Accepted: 7/9/2011
Published online: 11/12/2011

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT

Abstract

Objective: To evaluate pre-intervention echocardiographic parameters of cardiac function in fetuses who survive without hydrops as compared to fetuses who develop hydrops or perinatal death in the setting of sacrococcygeal teratoma (SCT) and twin-reversed arterial perfusion sequence (TRAP). Methods: Clinical, echocardiographic and sonographic data of fetuses with SCT or TRAP during 1999–2009 were reviewed retrospectively. Measurements of cardiothoracic ratio (CTR), cardiac dimension Z-scores, combined ventricular output (CVO), valvular regurgitation, and cardiovascular profile scores (CVPS) were obtained. Results: In total, 19 fetuses (11 SCT, 8 TRAP) met the inclusion criteria and 26 detailed fetal echocardiographic studies were reviewed. Outcome was poor in 7 pregnancies (group A) and good in 12 (group B). Group A had worse CVPS (8.5 vs. 10, p < 0.01) and higher CTR (0.37 vs. 0.30, p = 0.04). At least one of the following was present in each group A fetus: CTR >0.5, CVO >550 ml/min/kg, tricuspid or mitral regurgitation, or mitral valve Z-score >2. No group B fetus had any of these abnormalities. No fetus in either group had abnormal venous Doppler waveforms at presentation. Conclusions: Fetal echocardiography can identify abnormalities of cardiac size and systolic, but not diastolic, function in all fetuses who subsequently died or developed hydrops.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 2/17/2011 7:47:13 PM
Accepted: 7/9/2011
Published online: 11/12/2011

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 4

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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