Prenatal diagnosis · 2025
Pregnancy Complications in Fetal Congenital Heart Disease: A Result of Common Early Developmental Pathways Rather Than Fetal Hemodynamics.
СтатьяНазвание и аннотация: Перевод в очереди
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Snoep Maartje C, Demir Damla, Roestenburg Anouk M C, Pajkrt Eva, van Leeuwen Elisabeth, Linskens Ingeborg H, Knobbe Ingmar, Clur Sally-Ann, Rozendaal Lieke, van der Meeren Lotte E, Haak Monique C
Аннотация
OBJECTIVE: The aim of this study was to compare placenta-related complications (adverse placental syndrome) between different types of fetal CHD based on cardiac hemodynamics.
METHOD: All CHD cases diagnosed prenatally by fetal ECHO during 2009-2023 were selected. Exclusion criteria were as follows: multiple pregnancies, pregnancy termination, known genetic aberrations, and extracardiac anomalies. Cases were categorized into 6 groups based on theorized hemodynamic factors. Reference values for fetal growth restriction (FGR), preeclampsia (PE), pregnancy induced hypertension (PIH), and intra uterine fetal demise (IUFD) from the overall Dutch and/or European population were used.
RESULTS: After exclusion, 1293 cases were available for analysis. The incidence of FGR was 198/1247 (15.9%). There was a significant difference in FGR between the groups of CHD (p = 0.002) though it could not be correlated with aortic flow and oxygenation. There was a high incidence of PE (64/1282, 5.0%), PIH (43/1284, 3.3%), and IUFD (33/1291, 2.6%) in our cohort as compared to reference values. Nonetheless, there were no differences in PE, PIH, and IUFD between the different CHD groups.
CONCLUSION: A high incidence of adverse placental syndrome was found though this could not be related to fetal hemodynamics. Even in CHDs without hemodynamic changes, a high incidence of these complications was found. This might be a clinical manifestation of early embryological developmental pathways that affect both the placenta and the fetal heart.
METHOD: All CHD cases diagnosed prenatally by fetal ECHO during 2009-2023 were selected. Exclusion criteria were as follows: multiple pregnancies, pregnancy termination, known genetic aberrations, and extracardiac anomalies. Cases were categorized into 6 groups based on theorized hemodynamic factors. Reference values for fetal growth restriction (FGR), preeclampsia (PE), pregnancy induced hypertension (PIH), and intra uterine fetal demise (IUFD) from the overall Dutch and/or European population were used.
RESULTS: After exclusion, 1293 cases were available for analysis. The incidence of FGR was 198/1247 (15.9%). There was a significant difference in FGR between the groups of CHD (p = 0.002) though it could not be correlated with aortic flow and oxygenation. There was a high incidence of PE (64/1282, 5.0%), PIH (43/1284, 3.3%), and IUFD (33/1291, 2.6%) in our cohort as compared to reference values. Nonetheless, there were no differences in PE, PIH, and IUFD between the different CHD groups.
CONCLUSION: A high incidence of adverse placental syndrome was found though this could not be related to fetal hemodynamics. Even in CHDs without hemodynamic changes, a high incidence of these complications was found. This might be a clinical manifestation of early embryological developmental pathways that affect both the placenta and the fetal heart.