[THE FINDINGS AND CHAIN OF EVENTS THAT LED PREGNANT WOMEN TO TERMINATION OF PREGNANCY DUE TO FETAL HEART DEFECTS: 17 YEARS EXPERIENCE FROM A SINGLE MEDICAL CENTER].

OBJECTIVES

The study aimed to assess the fetal heart defects that led to termination of pregnancy (TOP), the weeks' gestation that the defect was first diagnosed, whether TOP was conducted and the timeline of events that led to the decision. This is in order to encourage pregnant women to conduct sonographic screening tests that are recommended during pregnancy.

METHODS

All pregnant women with singleton pregnancy who underwent TOP in our institute because of fetal heart defects as an only finding between 2000-2017 were included. TOPs preformed because of multisystem defects, abnormal karyotype and chromosomal or genetic defect were excluded. The patients were stratified into late TOP (≥24 weeks' gestation) and early TOP (<24 weeks' gestation).

RESULTS

There were 3469 TOP and 228 (6.5%) cases because of fetal heart defects as the only abnormal finding. Of these cases, 191 (83.7%) and 37 (16.3%) were conducted before and after 24 weeks' gestation respectively. The mean weeks' gestation during which the heart defect was first diagnosed and TOP was conducted was 18.7±4.1 and 20.6± 3.7 respectively. The single most common heart defect was of the ventricular outflow tract that was found in 102 cases (44.7%), followed by functionally univentricular heart in 79 cases (34.6%). A combination of two defects was found in 5 cases (2.2%) and was mostly diagnosed after 24 weeks' gestation. Out of all cases 16.8% did not go through early fetal anomaly scan (conducted between 14-16 weeks' gestation), compared to 66.7% of late TOP cases; 22.2% of cases were not diagnosed during routine anomaly scans.

CONCLUSIONS

In most cases the fetal heart defect was diagnosed during routine 14-16 gestational weeks anomaly scan.

DISCUSSION

This information should encourage pregnant women to perform timely sonographic scanning.