Rasouli Saeid, Radgoodarzi Mohammad, Azarbad Reza, Ghazvini Azim, Sotoudeheian Mohammadjavad, Taghizadeh Mehdi, Dakkali Mohammad Sedigh
Pediatrics, Iran University of Medical Sciences, Tehran, IRN.
Pediatric Cardiology, Iran University of Medical Sciences, Tehran, IRN.
Cureus. 2024 Feb 24;16(2):e54810. doi: 10.7759/cureus.54810. eCollection 2024 Feb.
Introduction Congenital heart defects (CHD) are one of the most common congenital anomalies, and their association with assisted reproductive technology (ART) is controversial in different populations. The purpose of this study was to evaluate this association and to provide information about the necessity of specialized echocardiography during pregnancy with ART. Methods This retrospective study was performed on all pregnancies conceived by ART and referred for fetal echocardiography to the Rasoul Akram and Akbar Abadi hospitals in Tehran, Iran. A total of 109 patients were enrolled in the study (56 in the ART group and 53 in the non-ART). Two-dimensional and color Doppler echocardiography were performed on all patients to identify heart problems and anomalies and medical records of the patients were reviewed. The outcome was considered the presence of functional and structural heart defects on echocardiography. Results The study groups were similar in terms of maternal age and GA. The ART group consisted of 31 singletons (55%) and 25 multiples (45%). All pregnancies in the non-ART group were singletons. Following in vitro fertilization (33%), ovulation induction (25%) was the next most used method. The findings of echocardiography were one atrial septal defect (ASD) in ART and one in non-ART, six ventricular septal defects (VSD) in ART and three in non-ART, and one ASD and VSD in the ART group. These structural abnormalities showed no difference in the two groups (P value = 0.58). There was no significant difference in rhythm between the two groups (P = 0.51). Echocardiographic indices of both groups did not differ statistically except in the TR-PG index (P value = 0.02). Conclusions The structural defects of the two groups were not different, and no heart dysfunction was observed in ART fetuses. There was no association between ART and CHD in our study. We concluded that echocardiography by pediatric cardiologists is not necessary for these fetuses.
引言
先天性心脏病(CHD)是最常见的先天性畸形之一,其与辅助生殖技术(ART)的关联在不同人群中存在争议。本研究的目的是评估这种关联,并提供有关ART妊娠期间进行专门超声心动图检查必要性的信息。
方法
本回顾性研究针对所有通过ART受孕并转诊至伊朗德黑兰拉苏勒·阿克拉姆医院和阿克巴尔·阿巴迪医院进行胎儿超声心动图检查的妊娠病例。共有109例患者纳入研究(ART组56例,非ART组53例)。对所有患者进行二维和彩色多普勒超声心动图检查以识别心脏问题和异常,并查阅患者的病历。结局指标为超声心动图检查发现的功能性和结构性心脏缺陷。
结果
两组在产妇年龄和孕周方面相似。ART组包括31例单胎妊娠(55%)和25例多胎妊娠(45%)。非ART组所有妊娠均为单胎妊娠。在体外受精之后(33%),其次最常用的方法是促排卵(25%)。超声心动图检查结果显示,ART组有1例房间隔缺损(ASD),非ART组有1例;ART组有6例室间隔缺损(VSD),非ART组有3例;ART组有1例ASD合并VSD。两组的这些结构异常无差异(P值 = 0.58)。两组在心律方面无显著差异(P = 0.51)。除三尖瓣反流压差(TR-PG)指数外,两组的超声心动图指标在统计学上无差异(P值 = 0.02)。
结论
两组的结构缺陷无差异,ART胎儿未观察到心脏功能障碍。本研究中ART与CHD之间无关联。我们得出结论,这些胎儿无需儿科心脏病专家进行超声心动图检查。