Prenatal diagnosis, management, and outcomes of fetuses with tetralogy of Fallot in China after prenatal counseling: a prospective cohort study

Frontiers in Pediatrics

Pediatrics

Ting Lu¹  Tao Qian¹  Yu-hong Liu¹  Deng-pu Deng¹  Zhong-shi Wu² 

[1] Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, China;Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, China;National Health Commission Key Laboratory of Birth Defects Research, Prevention, and Treatment, China;

关键词: tetralogy of Fallot;    pregnancy;    heart defects;    fetal cardiology;    fetal echocardiography;   

DOI  :  10.3389/fped.2023.1172282

 received in 2023-02-23, accepted in 2023-07-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveThe study aimed to monitor fetuses with tetralogy of Fallot (TOF) after prenatal counseling and how it influenced the decision of parents to terminate the pregnancy.MethodsFetuses with isolated TOF diagnosed between January 2019 and December 2021 were prospectively enrolled. The follow-up period extended until termination or 6 months after the operation.ResultsOf the 1,026 fetuses diagnosed with cardiac defects, 129 were identified to have isolated TOF and completed the follow-up. A total of 55 (42.6%) fetuses were terminated, with larger maternal age (odds ratio: 0.893, 95% confidence interval: 0.806–0.989, P = 0.031) as the protective factor. The maternal anxiety score, gestational weeks, and pulmonary-to-aortic-diameter ratio lost significance in multivariate analysis. Subjectively, the two most common reasons for terminating the pregnancy were worries about the prognosis (41.8%) and concerns about the possible suffering of the unborn child (18.2%). The prenatal diagnosis was accurate in 73 of the 74 (98.6%) live births. Out of the 64 live births that underwent surgical repair in our center, 57 (89.1%) received primary repair, with a median age of 104 days, and 49 (76.6%) underwent valve-sparing repair. No perioperative death occurred.ConclusionsTermination for fetuses with TOF remains common in China. Live births with TOF can be safely and effectively managed.

【 授权许可】

Unknown   
© 2023 Deng, Qian, Liu, Wu and Lu.