Functional assessment of atrial wall excursion and foramen ovale flap tracings in 3rd trimester as predictor of short-term hemodynamic stability in congenital heart defects fetuses
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Oskar Sylwestrzak
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Iwona Strzelecka
Abstract
Objectives
Right atrium and left atrium of the fetal heart play a fundamental role in fetal heart circulatory physiology.
Methods
Excursion of fetal atria walls and tracings of foramen ovale (FO) flap movement were analyzed by M-mode echocardiography by new FO index to determine fetal and neonatal outcome in the first week and month of life in various congenital heart defects. The study group was divided into 3 subgroups: group A: neonates stable after birth (all on I.V. prostaglandin infusion) for at least 7 days, group B: neonates unstable after birth (despite I.V. prostaglandin infusion) requiring catheterization procedure or early cardiac surgery <6th day of life and group C: fetuses with in utero demise.
Results
The average values of FO index: group A – 32, group B – 20, group C – 12.Schaffe test showed statistical difference of FO index between group A and B (p=0.029) and group A and C (p=0.001), but no difference between group B and C (p=0.24) The FO index of stability was determined by ROC curve analysis. Cut-off point distinguishing between postnatal stability and postnatal instability + in utero demise constituted FO index=25 (specificity 82%; sensitivity 90%).
Conclusions
Prenatal features of atrial M-mode echocardiography shortly before birth might be helpful to predict the short term prognosis of fetal hemodynamic stability or instability shortly after birth regardless of the type of congenital heart defects (CHD).
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
References
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Articles in the same Issue
- Frontmatter
- Reviews
- Disquiet concerning cesarean birth
- Prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States: a systematic review and meta-analysis
- Corner of Academy
- Does COVID-19 infection acquired in different pregnancy trimester influence placental pathology?
- Original Articles – Obstetrics
- Did the first wave of the COVID-19 pandemic impact the cesarean delivery rate? A retrospective cohort study at a primary care center in Switzerland
- Hypertensive disorders of pregnancy and severe acute respiratory syndrome coronavirus-2 infection
- Hidden in plain sight in the delivery room – the Apgar score is biased
- Comparison of phase rectified signal averaging and short term variation in predicting perinatal outcome in early onset fetal growth restriction
- Serum levels of kynurenine in pregnancies with fetal growth restriction and oligohydramnios
- Effect of third trimester maternal vitamin D levels on placental weight to birth weight ratio in uncomplicated pregnancies
- One-third of patients with eclampsia at term do not have an abnormal angiogenic profile
- Chorioangioma: a single tertiary care center retrospective study
- A prospective cohort study: can advanced ultrasonography replace magnetic resonance imaging in the diagnosis of placental adhesion disorders?
- Original Articles – Fetus
- Fetal left brachiocephalic vein diameters in normal and growth restricted fetuses
- Functional assessment of atrial wall excursion and foramen ovale flap tracings in 3rd trimester as predictor of short-term hemodynamic stability in congenital heart defects fetuses
- Original Articles – Neonates
- Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program
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- Short Communication
- Prenatal care in the era of economic collapse
- Letters to the Editor
- Does fetus feel stress or pain on uterine contraction?
- Pregnancy associated plasma protein-A for the prediction of small for gestational age
- Reply to: Pregnancy associated plasma protein-A for the prediction of small for gestational age
