Causes and consequences of 93 fetuses with cardiomegaly in a tertiary center in Thailand.

OBJECTIVES

To assess etiology, perinatal mortality and associated factors of fetal cardiomegaly (FC).

METHODS

A retrospective study of fetuses with cardiomegaly was conducted. Demographic data, ultrasonographic findings, and outcomes were collected and analyzed.

RESULTS

Ninety-three fetuses were analyzed. The causes of FC were cardiac causes 49.5%, Bart's hemoglobinopathies 28%, and non-Bart's anemia 15%. Ascites, pericardial effusion, and hydrops were more prevalent in fetuses with anemia than those with cardiac abnormalities. The overall perinatal mortality was 69.9%. Although all Bart's hydrops died, perinatal mortality of non-Bart's anemia, and structural cardiac defect were 57.1 and 69.7%, respectively. Excluding Bart's anemia, receiver-operating characteristic curve analysis demonstrated that cardiothoracic ratio of ≥0.58 best predictive for perinatal mortality. Earlier gestational age at diagnosis, skin edema, and chromosomal abnormality were associated with higher mortality.

CONCLUSIONS

Majority causes of FC were cardiac and anemic in origin. It carried high-perinatal mortality depending on the causes.