Fetal Kardiyovasküler Sistem Anomalilerinin Prenatal Tanılarının, Kısa Dönem Neonatal Sonuçlarının ve Postnatal Tanılarının Retrospektif Olarak İncelenmesi

Abstract

In this study, obstetric and neonatal outcomes of pregnancies diagnosed with cardiovascular system (CVS) anomaly in the prenatal period, and follow-up and outcomes of newborns in the postnatal period were examined. Ventricular septal defects constituted 20.61% (n= 40) of congenital heart diseases (CHD), and was found most frequently. Second frequent CHD with 12.37% (n= 24) is hypoplastic left heart syndrome. Additional anomalies in systems other than CVS were detected in 14.94% (n=29) of all CVS anomalies (n=194). Skeletal system and extremity anomalies were found most frequently with a frequency of 4.12% (n=8). Karyotype analysis was performed in 25.77% (n=50) of CVS anomalies (n=194) diagnosed by antenatal USG, karyotype analysis results were normal in 19.07% (n=37) and 6.7% (n=13) were abnormal as a result of the karyotype analysis. Of the 193 patients whose pregnancy results were reached, 80.82% (n=156) resulted in live birth, 17.61% (n=34) resulted in assurance, and 1.55% (n=3) died in the intrauterine period. The highest termination rates were seen in the diagnosis of pulmonary atresia (40%), truncus arteriosus (33.3%) and HRHS (33.3%). The lowest live birth rate was found in patients with atrial isomerism (57.1%). HLHS (50%, 7/14%), truncus arteriosus (50%, 1/2) and atrial isomerism (40%, 2/5) groups are the most common groups in which babies are lost in the first 12 weeks without a chance for surgery. The groups in which babies lost in the first 12 weeks despite postnatal surgical intervention are most followed are AVSD (40%, 2/5), HLHS (28.6%, 4/14), DORV (28.6%, 4/14), atrial isomerism (20% , 1/5) and D-TGA (19%, 4/21). The groups followed with the highest survival after surgery were L-TGA (100%, 2/2), TOF (81.8%, 9/11) and HRHS (80%, 8/10). Detection of any CVS anomaly in the prenatal period is crucial to determine the possible cause, prognosis, and management. The nature of the diseases should be shared with families, and information should be given about the interventions and the process that may be necessary after birth. Physician knowledge is critical in processes requiring parental decisions, such as termination and karyotype analysis.