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Fetal heart diseases and neonatal mortality: Risk factors and management
Mucize Eric Ozdemir1, Oya Demirci2, Pinar Kumru2
1Perinatology Department, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey. ozdemir.mucize@gmail.com.
Archives of Gynecology and Obstetrics
|September 30, 2024
Summary
Fetal heart disease severity, low birth weight, and extracardiac anomalies significantly increase neonatal mortality risk. Careful consideration of labor induction methods is crucial for managing these high-risk pregnancies.
Area of Science:
- Cardiology
- Neonatal Medicine
- Obstetrics
Background:
- Fetal heart diseases are a major cause of neonatal mortality.
- Prenatal diagnostics are improving, necessitating personalized risk assessment and management strategies.
- Classifying fetal heart diseases by severity aids in counseling and delivery planning.
Purpose of the Study:
- To classify fetal heart diseases by severity.
- To examine maternal, fetal, and delivery factors impacting neonatal mortality.
- To identify key determinants for individualized risk assessment and management.
Main Methods:
- Prospective study of 382 pregnant women with fetal heart disease (2019-2023).
- Categorization into three risk groups based on hemodynamic instability potential.
- Antenatal follow-up with fetal echocardiography and analysis of associated factors.
Main Results:
- Neonatal mortality associated with birth weight < 2500g (p=0.002).
- Genitourinary anomalies (p=0.001) and high-risk heart disease (p<0.001) significantly increased mortality.
- Induction of labor showed a significant association with neonatal mortality (p=0.01).
Conclusions:
- Fetal heart disease severity, low birth weight, and extracardiac anomalies are key predictors of neonatal mortality.
- Labor induction with prostaglandin requires further validation but may increase mortality risk.
- Selective use of prostaglandin for labor induction in high-risk cases is suggested.
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