[Diagnostic and frequency of fetal heart disease by echocardiography in pregnancies with high-risk factors].

BACKGROUND

Fetal heart diseases are increasingly frequent. These are part of birth defects and, therefore, appear in early phases of the gestation. Diagnosis or early detection of functional and structural abnormalities of the heart allows to the obstetrician and the pediatric cardiologist to plan, in a timely manner, the treatment and prenatal and postnatal monitoring with the purpose of preventing complications.

OBJECTIVE

To determine the types and frequencies of heart diseases in pregnancies with high-risk factors.

PATIENTS AND METHOD

It was analized an observational, descriptive and retrospective series of cases. From January 2003 to June 2006, fetal echocardiograms were made in women with pregnancies longer than 15 weeks and with high-risk factors. At childbirth was made a cardiovascular evaluation. Analysis was carried out through descriptive statistics.

RESULTS

maternal age average was of 27.3 +/- 6.8 years; gestational age was of 31 +/- 5 weeks. In total, there were carried out 275 fetal echocardiograms (FE) in 208 patients; in 56 of them, was made one fetal ecocardiogram, two in 37 and three in 15. Risk factors of reference to the specialized medical unit were: abnormalities detected through obstetrical ultrasound (35.1%), tachycardia-bradycardia-arrhythmia (29.8%), probable chromosomic anomalies (13.9%), oligohydramnios or polyhydramnios (4.8%), familiar antecedents of congenital heart diseases (3.8%), others (12.6%). Heart disease was diagnosed by fetal echocardiogram in 55 patient (26.4%): unique ventricle (n = 5), hypoplastic right ventricle (n = 3), hypoplastic left ventricle (n = 4), congenital complete heart block (n = 1), Ebstein and dysplasia of the mitral and tricuspid valves (n = 12), tumor (n = 5), ectopia cordis (n = 2), auriculoventricular channel (= 1), supraventricular tachycardia (n = 4), supraventricular extrasystole (n = 3) and other. Diagnosis was confirmed at childbirth in 99.5% of the cases. The treatment was initiated in uterus for arrhythmia and cardiac insufficiency in 19 patients. The patients with high-risk cardiopathy (at birth) were evaluated at beginning through specialized cardiological treatment and then they were transferred to the service of pediatric cardiology.

CONCLUSIONS

Frequency of fetal heart diseases in patients with high-risk factors is of 25.4%. In these patients, the fetal echocardiogram (prenatal and postnatal) allows planning the optimal cardiological and obstetric treatment as well as to inform to the relatives.