Witkowski Sławomir, Respondek-Liberska Maria, Strzelecka Iwona
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital, Research Institute in Lodz, Poland.
Medical Faculty, Ludwik Rydygier Collegium Medicum, Poland.
J Ultrason. 2025 Apr 23;25(100):20250009. doi: 10.15557/jou.2025.0009. eCollection 2025 Jan.
Hypoplastic left heart syndrome is a severe congenital heart defect that may be accompanied by tricuspid and mitral valve regurgitation. The aim of this paper is to identify a new ultrasound marker for evaluating the outcomes of fetuses with hypoplastic left heart syndrome.
This was a single-center analysis of a group of fetuses who underwent fetal ultrasound examinations at our tertiary center between 2016 and 2023. This study included 80 fetuses with hypoplastic left heart syndrome. The gestational age of the studied fetuses ranged from 16.3 to 39.5 weeks. All anomalies and irregularities accompanying hypoplastic left heart syndrome were detected during the second and third trimesters of pregnancy.
Among fetuses with hypoplastic left heart syndrome with tricuspid regurgitation, the mortality rate was 0% (0/16) and the survival rate was 100% (16/16). In contrast, in fetuses with hypoplastic left heart syndrome with both tricuspid and mitral regurgitation, the mortality rate was 75% (3/4) and the survival rate was 25% (1/4). The incidence of death was significantly higher in the group of fetuses with hypoplastic left heart syndrome with both tricuspid and mitral regurgitation compared to the group with tricuspid regurgitation (Yates's chi-squared test: = 0.003; Fisher's test: = 0.0035).
The coexistence of hypoplastic left heart syndrome with tricuspid and mitral regurgitation is significantly associated with the death of newborns even when treatment and/or surgery is performed. Therefore, the presence of mitral regurgitation in fetuses with hypoplastic left heart syndrome may serve as an additional ultrasound marker for poor neonatal outcome.
左心发育不全综合征是一种严重的先天性心脏缺陷，可能伴有三尖瓣和二尖瓣反流。本文旨在确定一种新的超声标志物，用于评估左心发育不全综合征胎儿的预后。
这是一项对2016年至2023年在我们三级医疗中心接受胎儿超声检查的一组胎儿进行的单中心分析。本研究纳入了80例左心发育不全综合征胎儿。所研究胎儿的孕周为16.3至39.5周。在妊娠中期和晚期检测到所有伴随左心发育不全综合征的异常和不规则情况。
在患有三尖瓣反流的左心发育不全综合征胎儿中，死亡率为0%（0/16），存活率为100%（16/16）。相比之下，在患有三尖瓣和二尖瓣反流的左心发育不全综合征胎儿中，死亡率为75%（3/4），存活率为25%（1/4）。与仅有三尖瓣反流的胎儿组相比，患有三尖瓣和二尖瓣反流的左心发育不全综合征胎儿组的死亡发生率显著更高（Yates卡方检验：=0.003；Fisher检验：=0.0035）。
即使进行了治疗和/或手术，左心发育不全综合征合并三尖瓣和二尖瓣反流与新生儿死亡显著相关。因此，左心发育不全综合征胎儿中二尖瓣反流的存在可能作为新生儿预后不良的一个额外超声标志物。
