[Prospective study on the isolated ventricular septal defect in fetus]

Area of Science:

• Cardiology
• Prenatal Diagnosis
• Pediatric Cardiology

Background:

• Congenital heart defects are common birth defects.
• Isolated ventricular septal defects (VSD) can have significant morbidity and may close spontaneously.
• Limited research exists on VSD evolution from fetus to postnatal life.

Purpose of the Study:

• To determine the evolution of isolated VSD from fetal to postnatal life.
• To analyze the association between VSD diameter/location and spontaneous closure.

Main Methods:

• Prospective, longitudinal study of fetuses diagnosed with isolated VSD via echocardiography.
• Exclusion of fetuses with other malformations or chromosomal abnormalities.
• Follow-up until VSD closure, surgical repair, or percutaneous closure.

Main Results:

• Of 217 fetuses followed, 179 were delivered. Spontaneous VSD closure occurred in 45.2% (in utero: 27.4%, post-birth: 17.9%).
• Smaller VSDs (≤ 2.0 mm) had a higher spontaneous closure rate (59%) compared to larger ones (2.1-5.0 mm, 36%). VSDs > 5.0 mm did not close spontaneously.
• No significant difference in spontaneous closure rates was observed between perimembranous and muscular VSD locations.

Conclusions:

• Isolated VSD exhibits a high spontaneous closure rate during late pregnancy.
• The majority of postnatal VSDs spontaneously close within one year of age.
• VSD diameter is a significant factor in spontaneous closure, with smaller defects closing more frequently.