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Diagnosis and treatment of foetal heart failure: foetal echocardiography and foetal hydrops*

Published online by Cambridge University Press:  17 September 2015

James C. Huhta
James C. Huhta*
Affiliation:
Perinatal Cardiology, All Children’s Hospital, St. Petersburg, Florida, United States of America Fetal Cardiology, Mednax Inc., Sunrise, Florida, United States of America University of Florida, Gainsville, Florida, United States of America
*
Correspondence to: J. Huhta, MD, 601 5th St. South #711, St. Petersburg, FL 33701, United States of America. Tel: +727 368 6432; Fax: +727 821 2461; E-mail: [email protected]
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Abstract

Foetal echocardiography has progressed to be able to diagnose many forms of CHD and to assess the prognosis of cardiac lesions based on their anatomy and presentation in utero. This article outlines a straightforward method for the rapid evaluation of foetus that may have congestive heart failure with or without hydrops and for the differentiation of the pre-hydropic state from normal. The presence of signs of foetal heart failure, such as cardiomegaly or valvular regurgitation, gives clues to the aetiology of hydrops. The assessment of the prognosis of hydrops foetalis can be difficult but can be aided by the use of the cardiovascular profile score. Once identified, the neurohumoral effects of foetal heart failure can be ameliorated using transplacental digoxin if the hydrops has not progressed.

Keywords

Foetalcongestive heart failureCHDhydrops foetalisDoppler echocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Supplement S2: Special Supplement of Cardiology in the Young: Proceedings of the 2015 International Paediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute , August 2015 , pp. 100 - 106
Copyright
© Cambridge University Press 2015 

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Footnotes

*

Presented at Johns Hopkins All Children’s Heart Institute, International Pediatric Heart Failure Summit, Saint Petersburg, Florida, United States of America, 4–5 February, 2015.

References

1. Tongsong, T, Wanapirak, C, Piyamongkol, W, et al. Fetal ventricular shortening fraction in hydrops fetalis. Obstet Gynecol 2011; 117: 84–91.Google Scholar
2. Richards, A, Mao, CY, Dobson, NR. Left ventricular noncompaction: a rare cause of hydrops fetalis. Pediatr Cardiol 2009; 30: 985–988.Google Scholar
3. Abrams, ME, Meredith, KS, Kinnard, P, Clark, RH. Hydrops fetalis: a retrospective review of cases reported to a large national database and identification of risk factors associated with death. Pediatrics 2007; 120: 84–89.Google Scholar
4. Huang, HR, Tsay, PK, Chiang, MC, Lien, R, Chou, YH. Prognostic factors and clinical features in liveborn neonates with hydrops fetalis. Am J Perinatol 2007; 24: 33–38.Google Scholar
5. Gudmundsson, S, Huhta, JC, Wood, DC, Tulzer, G, Cohen, AW, Wein, S. Venous doppler ultrasonography in the fetus with nonimmune hydrops. Am J Obstet Gynecol 1991; 164: 33–37.Google Scholar
6. Falkensammer, CB, Paul, J, Huhta, JC. Fetal congestive heart failure: correlation of Tei-index and Cardiovascular-score. J Perinat Med 2001; 29: 390–398.CrossRefGoogle ScholarPubMed
7. Hofstaetter, C, Hansmann, M, Eik-Nes, SH, Huhta, JC, Luther, SL. A cardiovascular profile score in the surveillance of fetal hydrops. J Mater Fetal Neonat Med 2006; 19: 407–413.Google Scholar
8. Makikallio, K, Rasanen, J, Makikallio, T, Vuolteenaho, O, Huhta, JC. Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction. Ultrasound Obstet Gynecol 2008; 31: 48–54.Google Scholar
9. Donofrio, MT, Moon-Grady, AJ, Hornberger, LK, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014; 129: 2183–2242.Google Scholar
10. Tulzer, G, Gudmundsson, S, Wood, DC, Cohen, AW, Weiner, S, Huhta, JC. Doppler in non-immune hydrops fetalis. Ultrasound Obstet Gynecol 1994; 4: 279–283.Google Scholar
11. Mahle, WT, Rychik, J, Tian, ZY et al. Echocardiographic evaluation of the fetus with congenital cystic adenomatoid malformation. Ultrasound Obstet Gynecol 2000; 16: 620–624.Google Scholar
12. Respondek, ML, Kammermeier, M, Ludomirsky, A, Weil, SR, Huhta, JC. The prevalence and clinical significance of fetal tricuspid valve regurgitation with normal heart anatomy. Am J Obstet Gynecol 1994; 171: 1265–1270.Google Scholar
13. Neves, AL, Mathias, L, Wilhm, M, et al. Evaluation of prenatal risk factors for prediction of outcome in right heart lesions: CVP score in fetal right heart defects. J Mater Fetal Neonat Med 2014; 27: 1431–1437.Google Scholar
14. Tulzer, G, Gudmundsson, S, Huhta, JC, Wood, DC, Tews, G. The value of Doppler in evaluation and prognosis of fetuses with non-immunologic hydrops fetalis. Gynakol Rundsch 1991; 31 (Suppl 2): 152–153.Google Scholar