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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Cardiovascular profile and biophysical profile scores predict short-term prognosis in infants with congenital heart
Takekazu Miyoshi1,2, Shinji Katsuragi1, Reiko Neki1
1Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan.
Insights
Cardiovascular profile (CVP) and biophysical profile (BP) scores effectively predict perinatal outcomes in infants with congenital heart defects (CHD). A declining CVP score in utero indicates higher infant mortality risk, aiding management planning.
Area of Science:
- Perinatal cardiology
- Fetal medicine
- Pediatric cardiac surgery
Background:
- Accurate prenatal diagnosis is crucial for predicting prognosis in infants with congenital heart disease (CHD).
- Cardiovascular profile (CVP) and biophysical profile (BP) scores are prenatal assessment tools.
Purpose of the Study:
- To evaluate the utility of CVP and BP scores in predicting the prognosis of infants diagnosed with CHD prenatally.
- To identify specific CVP and BP score thresholds associated with adverse perinatal outcomes.
Main Methods:
- Retrospective review of singleton infants with prenatal CHD diagnosis.
- Analysis of data from a tertiary pediatric cardiac center (2011-2015).
- Correlation of CVP and BP scores with perinatal and infant mortality rates.
Main Results:
- Lower last CVP scores (≤5) and BP scores (≤6) were significantly associated with increased perinatal mortality (18.7-fold higher).
- A decreasing CVP score in utero correlated with a 4.5-fold higher infant mortality.
- Multivariate analysis identified single-ventricle physiology, preterm birth (<37 weeks), low CVP, and low BP scores as independent predictors of perinatal mortality.
Conclusions:
- CVP and BP scores are valuable tools for predicting perinatal prognosis in infants with CHD.
- A declining CVP score during gestation is a significant predictor of infant mortality.
- Serial CVP assessments may aid in planning management strategies for high-risk pregnancies.
Aim:
To predict the prognosis of infants with congenital heart disease, accurate prenatal diagnosis of structural abnormality and heart failure are both necessary. The aim of this study was to investigate whether cardiovascular profile (CVP) and biophysical profile (BP) scores are useful for predicting prognosis in infants with congenital heart defect (CHD).
Methods:
A retrospective review of singletons prenatally diagnosed with CHD at a tertiary pediatric cardiac center between 2011 and 2015 was undertaken.
Results:
A total of 202 patients with CHD were analyzed. Perinatal and infant deaths occurred in 16 (7.9%) and 10 cases (5.0%), respectively. Infants with the last CVP score ≤ 5 had 18.7-fold higher perinatal mortality than those with a last CVP score > 5 (P < 0.01). Infants with a last BP score ≤ 6 had 18.7-fold higher perinatal mortality than those with a last BP score > 6 (P < 0.01). Infants with a CVP score decrease in utero had 4.5-fold higher infant mortality than those with an increase or no change (P < 0.01). Multivariate analysis showed that single-ventricle physiology, pre-term birth at <37 weeks of gestation, last CVP score ≤ 5, and last BP score ≤ 6 were independent predictors of perinatal mortality. Single-ventricle physiology and a CVP score decrease were independent predictors of infant mortality.
Conclusion:
CVP and BP scores are useful for predicting perinatal prognosis in infants with CHD. A CVP score decrease in utero is associated with infant mortality, suggesting that serial CVP score assessment may be useful for management planning.
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