Cardiac axis in fetuses with abdominal wall defects.

Area of Science:

• Perinatology
• Fetal Cardiology
• Medical Imaging

Background:

• Abdominal wall defects (AWD) are congenital anomalies with potential implications for fetal development.
• The relationship between AWD and fetal cardiac morphology, specifically the cardiac axis, requires further investigation.
• Congenital heart disease (CHD) is a known complication in fetuses with AWD.

Purpose of the Study:

• To determine if fetal cardiac axis is altered by AWD independently of CHD.
• To assess the diagnostic value of fetal cardiac axis in predicting the absence of CHD in fetuses with AWD.

Main Methods:

• Retrospective review of video ultrasound records from fetuses diagnosed with AWD.
• Digitization and measurement of fetal cardiac axis from the four-chamber view by two independent examiners.
• Analysis of maternal and neonatal charts for confirmation of CHD and AWD type.

Main Results:

• A significant proportion of fetuses with AWD exhibited an abnormal cardiac axis (27%) compared to those with CHD (12%).
• Omphalocele was associated with a higher incidence of abnormal cardiac axis (59%) than gastroschisis (14%).
• A normal cardiac axis demonstrated a high negative predictive value (97.7%) for ruling out CHD in fetuses with AWD.

Conclusions:

• Fetal cardiac axis is frequently affected by AWD, irrespective of the presence of CHD.
• A normal fetal cardiac axis is a reliable indicator for the absence of CHD in fetuses diagnosed with AWD.
• This finding can aid in risk stratification and management of pregnancies complicated by AWD.