Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, India.
Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, India.
Cardiovasc Pathol. 2021 Mar-Apr;51:107312. doi: 10.1016/j.carpath.2020.107312. Epub 2020 Nov 17.
Major cardiac abnormalities can lead to miscarriages and is also an important indication of medical termination of pregnancy. The present study aims: (1) To determine the spectrum of cardiac anomalies in fetal autopsies, (2) To correlate the autopsy findings with prenatal imaging studies.
Fetal autopsies with cardiac anomalies were retrospectively analyzed over a period of five years. Autopsy diagnoses were correlated with prenatal ultrasound and echocardiogram findings.
Of the 177 fetal autopsies, 40 (22.5%) cases with cardiac defects were identified. Among these cases, 11 (27.5%) showed only cardiac defects and associated extracardiac malformations were seen in 29 cases (72.5%). Septal defects (45%) were the most frequent cardiac defect followed by left ventricular outflow tract obstruction. Agreement with prenatal imaging and autopsy findings was seen in 65% of cases. There was 100% concordance between autopsy and echocardiogram wherever available.
Cardiac malformation forms a significant subset of fetal congenital anomalies. Meticulous examination and following sequential segmental analysis during autopsy are essential in identifying complex cardiac and additional extra cardiac defects in the fetuses. Fetal autopsy plays a vital role in confirming and/or refuting the imaging findings and could be the steppingstone in understanding the pathogenesis of cardiac abnormalities.
严重的心脏异常可导致流产，也是终止妊娠的重要指征。本研究旨在：(1)确定胎儿尸检中心脏畸形的范围；(2)将尸检结果与产前影像学研究相关联。
对五年间进行的心脏异常胎儿尸检进行回顾性分析。将尸检诊断与产前超声心动图结果进行相关性分析。
在 177 例胎儿尸检中，发现 40 例(22.5%)存在心脏缺陷。在这些病例中，11 例(27.5%)仅存在心脏缺陷，29 例(72.5%)存在心脏缺陷合并其他心脏外畸形。室间隔缺损(45%)是最常见的心脏缺陷，其次是左心室流出道梗阻。在 65%的病例中，尸检与产前影像学结果具有一致性。在有条件进行超声心动图检查的情况下，尸检与超声心动图的一致性为 100%。
心脏畸形是胎儿先天性畸形的重要组成部分。在尸检中，仔细检查并进行连续节段性分析对于识别胎儿复杂的心脏和其他心脏外缺陷至关重要。胎儿尸检在确认和/或反驳影像学发现方面发挥着重要作用，并且可能是理解心脏异常发病机制的关键步骤。
