Ali Gedikbaşı1, Kazım Oztarhan2, Gökhan Yıldırım1, Ahmet Gül1, Emel Asar-Canaz1, Yavuz Ceylan1. 1. İstanbul Bakırköy Maternity and Children Diseases Hospital, Department of Obstetrics and Gynecology, Perinatology Unit, İstanbul, Turkey. 2. İstanbul Bakırköy Maternity and Children Diseases Hospital, Pediatric Cardiology, İstanbul, Turkey.
Abstract
OBJECTIVE: The aim of this study was to evaluate prognosis of types of ventricular septal defects and coexistence of associated cardiac and extracardiac defects. METHODS: 120 prenatal diagnosed pregnancies associated with ventricular septal pathology were retrospectively evaluated and divided into four groups, as atrioventricular septal defects, perimembranous septal defects, muscular septal defects and univentricular formation. Each group was divided further into four groups, as isolated defect, co-existing extracardiac defect, septal defect with extracardiac defect and septal defect with co-existing cardiac and extracardiac defect. Postnatal follow-up was continued at least until 8 months of life. RESULTS: Median gestational age at diagnosis was 26.3 weeks, 47 cases were diagnosed before 24 weeks. After dispersion of septal defects there was a statistical significance of p=0.0089 between groups. Of 31 cases with atrioventricular septal defects, only one case survived (3.2%) and there was a high association with extracardiac defects and abnormal karyotype (p=0.002). 69 cases with perimembranous ventricular septal defects were diagnosed, and 24 cases (34.8%) survived with significance for abnormal karyotype (p=0.039). Of 18 cases born with muscular septal defects 12 cases (66.7%) stay alive. We had two cases with univentricular structure; both cases decided for termination of pregnancy. CONCLUSION: The more complicated and severe the pathology, the worse the prognosis. Individualized counseling is the most important point in decision making together with families.
OBJECTIVE: The aim of this study was to evaluate prognosis of types of ventricular septal defects and coexistence of associated cardiac and extracardiac defects. METHODS: 120 prenatal diagnosed pregnancies associated with ventricular septal pathology were retrospectively evaluated and divided into four groups, as atrioventricular septal defects, perimembranous septal defects, muscular septal defects and univentricular formation. Each group was divided further into four groups, as isolated defect, co-existing extracardiac defect, septal defect with extracardiac defect and septal defect with co-existing cardiac and extracardiac defect. Postnatal follow-up was continued at least until 8 months of life. RESULTS: Median gestational age at diagnosis was 26.3 weeks, 47 cases were diagnosed before 24 weeks. After dispersion of septal defects there was a statistical significance of p=0.0089 between groups. Of 31 cases with atrioventricular septal defects, only one case survived (3.2%) and there was a high association with extracardiac defects and abnormal karyotype (p=0.002). 69 cases with perimembranous ventricular septal defects were diagnosed, and 24 cases (34.8%) survived with significance for abnormal karyotype (p=0.039). Of 18 cases born with muscular septal defects 12 cases (66.7%) stay alive. We had two cases with univentricular structure; both cases decided for termination of pregnancy. CONCLUSION: The more complicated and severe the pathology, the worse the prognosis. Individualized counseling is the most important point in decision making together with families.
Authors: L D Allan; G K Sharland; A Milburn; S M Lockhart; A M Groves; R H Anderson; A C Cook; N L Fagg Journal: J Am Coll Cardiol Date: 1994-05 Impact factor: 24.094
Authors: Mario A Cleves; Van H Savell; Sarika Raj; Weizhi Zhao; Adolfo Correa; Martha M Werler; Charlotte A Hobbs Journal: Birth Defects Res A Clin Mol Teratol Date: 2004-03