Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Department of Neonatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Reprod Sci. 2023 Sep;30(9):2805-2812. doi: 10.1007/s43032-023-01216-w. Epub 2023 Mar 29.
The purpose of this paper is to explore whether the cardiovascular profile score (CVPS) correlates with fetal outcome in patients with non-immune hydrops fetalis (NIHF) and cardiac anomalies. In this retrospective study, we included fetuses with NIHF and the suspicion of a cardiac anomaly in prenatal ultrasound. The CVPS was calculated using information obtained by fetal echocardiographic examination. Feto-neonatal mortality (FNM) was defined as intrauterine fetal demise or death in the first 6 months of life. We reviewed 98 patients, who were referred to the Department of Obstetrics and Gynecology of the Johannes Gutenberg University in Mainz with the diagnosis of NIHF between January 2007 and March 2021. By eighteen of them, the suspicion of a cardiac anomaly was raised. After exclusion of six pregnancies (one termination of pregnancy and five because of incomplete data), 12 cases were left for analysis. Mean gestational age at which the CVPS was calculated was 29 + 2 weeks. Two fetuses died in utero. Of the remaining ten hydropic fetuses, three newborns died in the neonatal period, and seven survived after a 6-month surveillance period. Median CVPS of all fetuses was 6 points. Surviving fetuses showed statistically significantly higher CVPS values (median 8 points) than fetuses with FNM (median 5 points, p value = 0.009). Our results point towards a positive association between CVPS and fetal outcome in fetuses with NIHF and cardiac anomalies. The CVPS appears to be a useful marker in the assessment of heart failure in utero.
本文旨在探讨心血管特征评分（CVPS）与非免疫性胎儿水肿（NIHF）伴心脏畸形患者的胎儿结局是否相关。在这项回顾性研究中，我们纳入了产前超声检查怀疑 NIHF 伴心脏畸形的胎儿。CVPS 通过胎儿超声心动图检查获得的信息进行计算。围产儿死亡率（FNM）定义为宫内胎儿死亡或出生后 6 个月内死亡。我们回顾了 2007 年 1 月至 2021 年 3 月期间因 NIHF 被转诊至美因茨约翰内斯古腾堡大学妇产科的 98 例患者。其中 18 例患者怀疑有心脏畸形。排除 6 例妊娠（1 例终止妊娠，5 例因数据不完整）后，12 例妊娠用于分析。计算 CVPS 的平均孕龄为 29+2 周。2 例胎儿宫内死亡。在其余 10 例水肿胎儿中，3 例新生儿在新生儿期死亡，7 例在 6 个月的随访期后存活。所有胎儿的 CVPS 中位数为 6 分。存活胎儿的 CVPS 值（中位数 8 分）明显高于 FNM 胎儿（中位数 5 分，p 值=0.009）。我们的结果表明，CVPS 与 NIHF 伴心脏畸形胎儿的胎儿结局呈正相关。CVPS 似乎是评估宫内心力衰竭的有用标志物。
