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Dilated cardiomyopathy presenting during fetal life.
Sivasubramonian Sivasankaran1, Gurleen K Sharland, John M Simpson
1Department of Congenital Heart Disease, Guy's Hospital, Fetal Cardiology Unit, London, United Kingdom.
Cardiology in the Young
|July 15, 2005
Summary
Fetal dilated cardiomyopathy has various causes including genetic, metabolic, and infective conditions. Hydropic fetuses have a poor prognosis, with high rates of intrauterine and neonatal death.
Area of Science:
- Cardiology
- Fetal Medicine
- Genetics
Background:
- Fetal dilated cardiomyopathy is a serious condition affecting heart function in utero.
- Understanding its causes and outcomes is crucial for improving fetal care.
Purpose of the Study:
- To detail the echocardiographic findings, etiological factors, and prognosis of fetuses diagnosed with dilated cardiomyopathy.
- To identify risk factors influencing survival rates in affected fetuses.
Main Methods:
- Retrospective observational study of 50 fetuses with dilated cardiomyopathy (1983-2003) at a tertiary fetal cardiology center.
- Inclusion criteria: ventricular dilation and reduced systolic function; exclusion criteria: abnormal cardiac connections, valve stenosis, arrhythmias.
- Analysis of identified causes, pregnancy outcomes, and survival rates.
Main Results:
- Cardiomyopathy causes identified in 74% of cases: genetic/metabolic (11), infective (11), fetal anemia (5), cardiac origin (5), renal disease (5).
- Pregnancy termination occurred in 20% of cases.
- Survival rates: 62.5% to delivery, 42.5% at 28 days, 37.5% at 1 year.
- Survival was significantly lower in hydropic fetuses (18%) compared to non-hydropic fetuses (50%).
Conclusions:
- Dilated cardiomyopathy in fetuses can stem from genetic, metabolic, infective, or cardiac origins.
- High rates of intrauterine and early neonatal mortality are observed.
- Hydropic fetuses face a particularly poor prognosis, underscoring the need for targeted interventions.