Pregnancy and early post-natal outcomes of fetuses with functionally univentricular heart in a low-and-middle-income country.

Abstract:

BACKGROUND:Care of children with functionally univentricular hearts is resource-intensive. OBJECTIVES:To analyse pregnancy and early post-natal outcomes of fetuses with functionally univentricular hearts in the setting of a low-middle-income country. METHODS:A retrospective study was conducted during the period of January 2008-October 2019. Study variables analysed included gestational age at diagnosis, maternal and fetal comorbidities and cardiac diagnosis including morphologic type of single ventricle. Outcomes analysed included pregnancy outcomes, type of post-natal care and survival status on the last follow-up. RESULTS:A total of 504 fetuses were included. Mean maternal age was 27.5 ± 4.8 years and mean gestational age at diagnosis was 25.6 ± 5.7 weeks. Pregnancy outcomes included non-continued pregnancies (54%), live births (42.7%) and loss to follow-up (3.3%). Gestational age at diagnosis was the only factor that impacted pregnancy outcomes (non-continued pregnancies 22.5 ± 3.5 vs. live births 29.7 ± 5.7 weeks; p < 0.001). Of the 215 live births, intention-to-treat was reported in 119 (55.3%) cases; of these 103 (86.6%) underwent cardiac procedures. Seventy-nine patients (36.7%) opted for comfort care. On follow-up (median 10 (1-120) months), 106 patients (21%) were alive. Parental choice of intention-to-.treat or comfort care was the only factor that impacted survival on follow-up. CONCLUSIONS:Prenatal diagnosis of functionally univentricular hearts was associated with overall low survival status on follow-up due to parental decisions on not to continue pregnancy or non-intention-to-treat after birth. Early detection of these complex defects by improved prenatal screening can enhance parental options and reduce resource impact in low-and-middle-income countries.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Vaidyanathan B,Vijayaraghavan A,Thomas S,Sudhakar A

doi

10.1017/S1047951120002929

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

1844-1850

issue

12

eissn

1047-9511

issn

1467-1107

pii

S1047951120002929

journal_volume

30

pub_type

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