Counseling and outcomes of antenatally diagnosed congenital heart anomalies in Turkey


Gedikbasi A., Oztarhan K., Yildirim G., Gul A., Ceylan Y.

ANATOLIAN JOURNAL OF CARDIOLOGY, cilt.11, sa.2, ss.137-145, 2011 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 11 Sayı: 2
  • Basım Tarihi: 2011
  • Doi Numarası: 10.5152/akd.2011.035
  • Dergi Adı: ANATOLIAN JOURNAL OF CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.137-145
  • İstanbul Üniversitesi Adresli: Hayır

Özet

Objective: To determine the clinical outcomes and decisions of families of fetuses with prenatally-diagnosed cardiac abnormalities. Methods: Prenatally diagnosed cases (n=155) with congenital heart disease were retrospectively categorized according to the Allan-Huggon grading system: Group A (cardiac disease associated with severe / lethal extracardiac disease); Group B1 (low risk with a postnatal prognosis); Group B2 (moderate risk, amenable to surgical repair with a low mortality); and Group B3 (high risk, associated with high mortality after surgery). Neonatal outcomes, including termination of pregnancy, were recorded for 18 months of follow-up after counseling the parents. Student's t-test, Mann-Whitney U, Pearson's Chi-square test and Fischer's exact Chi-square test were used for statistical analyses. Results: One hundred forty-five cases completed follow up. Thirty-nine cases (Group A) were associated with extracardiac lethal defects and the pregnancies were terminated; these cases were excluded from statistical evaluation. Twenty parents in Group B3 opted also for termination. The survival rates of ongoing pregnancies after 18 months of follow-up between the three cardiac abnormality Groups (Group B1, n=37; Group B2, n=12; and Group 133, n=37) were 89.2%, 66.7%, and 13.5%, respectively. Significance was present between the survival rates of the three Groups [Group B3 vs. Group B1: p=0.0001; OR: 52.8 (12.9-214.5); Group B3 vs. Group B2: p=0.0009; OR: 12.8 (2.8-58.9); Group B2 vs. Group B1: p=0.087; OR: 4.12 (0.84-20.2)] Conclusion: Our practice and the findings reported herein support the efficacy of this staging system and counseling parents of fetuses for congenital heart diseases. (Anadolu Kardiyol Berg 2011; 11: 137-45)