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Features and outcomes in utero and after birth of fetuses with myocardial disease

Vlasta Fesslova1, Maurizio Mongiovì, Salvatore Pipitone

  • 1Center of Fetal Cardiology, Policlinico San Donato IRCCS, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy.

International Journal of Pediatrics
|October 27, 2010
PubMed

Insights

Fetal cardiomyopathy (dilated cardiomyopathy, hypertrophic cardiomyopathy) and myocarditis present a severe prognosis, particularly when associated with hydrops fetalis or extracardiac anomalies. Early diagnosis and management are crucial for improved outcomes.

Area of Science:

  • Cardiology
  • Fetal Medicine
  • Pediatric Cardiology

Background:

  • Cardiomyopathies and myocarditis are significant causes of fetal cardiac dysfunction.
  • Understanding their impact on fetal outcomes is critical for prenatal counseling and management.

Purpose of the Study:

  • To investigate the prognosis and outcomes of fetuses diagnosed with dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and myocarditis.
  • To identify factors influencing survival and disease progression in these fetal cardiac conditions.

Main Methods:

  • Retrospective study of 91 fetuses diagnosed with DCM, HCM, or myocarditis.
  • Analysis of associated conditions such as hydrops fetalis (FH) and extracardiac anomalies (ECAs).
  • Review of pregnancy outcomes, including termination, mortality, and postnatal follow-up.

Main Results:

  • Dilated cardiomyopathy (DCM) and myocarditis groups showed high mortality rates (68.75% and 63.6%, respectively).
  • Hypertrophic cardiomyopathy (HCM) had a lower mortality rate (31.3%), especially in cases without severe ECAs.
  • Survivors with DCM and myocarditis generally improved, while some HCM cases worsened or stabilized.

Conclusions:

  • Fetal DCM and myocarditis carry a more severe prognosis compared to HCM.
  • The presence of severe extracardiac anomalies significantly worsens the outlook for fetuses with cardiomyopathy and myocarditis.
  • Outcomes vary, with some fetuses improving while others experience worsening or stable conditions postnatally.

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