Onur Erol1, Osman Sevket2, Seda Keskin2, Hasan Fehmi Yazıcıoğlu2, Ahmet Gül3. 1. Department of Obstetrics and Gynecology, Antalya Training and Research Hospital, Antalya, Turkey. 2. Department of Obstetrics and Gynecology, Süleymaniye Maternity Research and Training Hospital İstanbul, Turkey. 3. Department of Obstetrics and Gynecology, İstanbul Prenatal Center, İstanbul, Turkey.
Abstract
OBJECTIVE: To evaluate the natural history of isolated muscular ventricular septal (m-VSD) defects during gestation and up to 1 year postnatally, as well as the association with chromosomal anomalies. MATERIAL AND METHODS: Between August 2007 and July 2012, 76 fetuses with isolated m-VSDs represented the study population. The following variables were evaluated: site and size of the m-VSDs, presence of chromosomal anomalies, pregnancy outcome, and spontaneous closure rate from diagnosis up to 1 year postnatally. RESULTS: Of the 76 cases with m-VSD, 1 fetus died after birth and 31 cases were lost to follow-up after birth. Thus, a total of 44 fetuses reached their first year of postnatal life, and these cases were available for analysis. Three (6.8%) of 44 defects closed spontaneously in utero, 33 (75%) closed within 1 year, and 8 (18.2%) remained patent. Overall, spontaneous closure occurred more frequently in the apical defects, but no significant difference was found for spontaneous closure between the mid-muscular and apical defects (p>0.05). Also, 83.8% (36 of 44) of defects ≤3 mm closed during gestation or the first year of life. CONCLUSION: We infer that m-VSDs have a high spontaneous closure rate during the first year of life. Also, small m-VSDs frequently close spontaneously.
OBJECTIVE: To evaluate the natural history of isolated muscular ventricular septal (m-VSD) defects during gestation and up to 1 year postnatally, as well as the association with chromosomal anomalies. MATERIAL AND METHODS: Between August 2007 and July 2012, 76 fetuses with isolated m-VSDs represented the study population. The following variables were evaluated: site and size of the m-VSDs, presence of chromosomal anomalies, pregnancy outcome, and spontaneous closure rate from diagnosis up to 1 year postnatally. RESULTS: Of the 76 cases with m-VSD, 1 fetus died after birth and 31 cases were lost to follow-up after birth. Thus, a total of 44 fetuses reached their first year of postnatal life, and these cases were available for analysis. Three (6.8%) of 44 defects closed spontaneously in utero, 33 (75%) closed within 1 year, and 8 (18.2%) remained patent. Overall, spontaneous closure occurred more frequently in the apical defects, but no significant difference was found for spontaneous closure between the mid-muscular and apical defects (p>0.05). Also, 83.8% (36 of 44) of defects ≤3 mm closed during gestation or the first year of life. CONCLUSION: We infer that m-VSDs have a high spontaneous closure rate during the first year of life. Also, small m-VSDs frequently close spontaneously.