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Fetal Surgery for Congenital Heart Diseases: A Systematic Review and Single-Arm Meta-analysis
Larissa Keren de Azevedo Teixeira1, Henrique Provinciatto2, Gustavo Yano Callado3
1Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul, SP, Brazil.
Advances in Therapy
|October 18, 2025
Summary
Fetal cardiac interventions (FCI) for congenital heart diseases (CHD) show moderate survival rates but high perinatal mortality. Improved patient selection and standardized protocols are crucial for better outcomes in fetal cardiac interventions.
Area of Science:
- Cardiology
- Fetal Medicine
- Pediatric Surgery
Background:
- Congenital heart diseases (CHD) are the most common congenital anomalies.
- Fetal cardiac interventions (FCI) aim to improve perinatal outcomes for fetuses with CHD.
Purpose of the Study:
- To systematically review and meta-analyze observational studies on the effects of FCI on CHD.
- To evaluate the efficacy and safety of intrauterine procedures for fetal cardiac conditions.
Main Methods:
- Systematic search of PubMed/Medline, Embase, and Cochrane Central Register.
- Inclusion of observational cohort studies evaluating intrauterine procedures for CHD.
- Random effects models used for data synthesis; study quality assessed using NOS.
Main Results:
- Analysis of 12 studies with 485 fetuses with CHD.
- Pooled overall survival rate after FCI was 57.4% (95% CI 39.8-73.3).
- Pooled perinatal mortality rate was 31.5% (95% CI 21.0-44.2), with significant heterogeneity observed.
Conclusions:
- FCI for CHD are linked to moderate survival and substantial perinatal mortality.
- Need for standardized protocols, refined patient selection, and multicenter collaboration.
- Improvements are necessary to enhance outcomes and guide clinical decision-making for FCI in CHD.
