gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

A clinical importance of detecting a heart defect classified as Fallot?s syndrome in prenatal examinations


Abstract

Author(s): ANNA TOPORSKA1, AGATA WŁOCH2, STANISŁAW WŁOCH3, JACEK MAGNUCKI4,AGNIESZKA KOBIOŁKA1, KRZYSZTOF SODOWSKI2, VIOLETTA SKRZYPULEC-PLINTA1

Introduction. Prenatal ultrasound tests with a fetal heart echocardiogram serve nowadays asa diagnostic method in pregnancy for evaluating the developing fetus. Prenatal echocardio-graphy makes it possible to detect fetal heart defects, some of them even in the first trimesterof pregnancy. Defects of the arterial cone include the classic form of the tetralogy of Fallot(ToF), Fallot’s syndrome with aorto-pulmonary window attresia (ToF+AP) and Fallot’s syn-drome with absent pulmonary valve (ToF+APV).Aim of the study. An analysis of clinical data and the history of fetuses and newborns withprenatal diagnosis of Fallot’s syndrome.Material and methods. The data of 43 patients with diagnosed fetal Fallot’s syndrome wereanalysed, basing on the records at the National Register of Fetal Cardiologic Pathologies (ORPKP)in the period of 2006-2010, coming from the reference centre of type C in Ruda Œl¹ska. Theaverage age of the women referred for prenatal ultrasound tests was 30.6 +/- 4 (from 20 to 39).Results. Fallot’s syndrome was the fourth most frequent heart defect diagnosed in prenatalultrasound tests reported in the ORPKP database. The most frequently detected form was theclassic tetralogy of Fallot - in 27 (63%) cases, then - ToF+AP in 12 (28%) cases, and ToF+APVin 4 (9%) cases. Indications for prenatal ultrasound tests included: an bnormal picture of thefour fetal heart chambers in 38 (88%) cases, a widening of nuchal translucency in 4 (10%)cases and a chronic disease in the pregnant woman in 1 (2%) case. Among the fetuses withFallot’s syndrome, 3 (13%) cases of chromosomal aberration were diagnosed: 1x triploidy, 1xtrisomy 18, 1x Down syndrome, and developmental anomalies were detected in 4 (9%) cases.Conclusions. Prenatal detection of ToF is becoming increasingly possible in the first trimesterof pregnancy. Prenatal diagnosing with the use of echocardiography makes it possible to identifythe accompanying defects and genetic diseases as well as to determine prognoses for the fetusesand children with heart defects