CLINICAL CHARACTERISTICS OF PREGNANT WOMEN WITH ISOLATED CONGENITAL HEART DEFECTS IN THE FETUS
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Keywords

pregnancy, congenital heart defects, prenatal diagnosis, selection criteria

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Dudierina , Y., Govsieiev , D., Galagan , V., & Kurkevych , A. (2021). CLINICAL CHARACTERISTICS OF PREGNANT WOMEN WITH ISOLATED CONGENITAL HEART DEFECTS IN THE FETUS. Medical Science of Ukraine (MSU), 17(4). https://doi.org/10.32345/2664-4738.4.2021.08

Abstract

Relevance. Cardiovascular pathology today remains one of the main causes of morbidity, mortality and early disability in populations; occupies a leading place among developmental defects in children (up to 30 %). Received data from European and domestic studies indicate an increase in the frequency of the congenital heart defects, which is in the range of 8 -9 per 1,000 live births, depending on geographical differences. Despite significant progress in understanding the mechanisms that determine the formation and development of the heart, causes of the isolated congenital heart defects, in most cases, remain uncertain; they require study of the interaction of many factors, both in the prenatal and in the postnatal period.

Objective.  Assessment of clinical diagnostic criteria of pregnant women with isolated congenital heart defects in the fetus for determination of the stages and multidisciplinary approach of their management. 

Materials and methods. For the period 2020-2021, 30 pregnant women aged 17 to 39 years were examined on the basis of a hospital sample, with various forms of isolated congenital heart defects who were directed from different regions of Ukraine. The work was conducted on the basis of clinical prospective studies on the basis of an obstetric department CCE KCMH № 5. The selection criteria included: somatically healthy women in term 18-39 weeks of pregnancy, with unencumbered pregnancy, natural fertilization, the presence of an isolated heart defect in the fetus, the absence of a risk for chromosomal pathology in the fetus. Stages in the management of pregnant women using a multidisciplinary approach were determined. Common clinical, instrumental and statistical methods were used during the study.

Results. The average age of women with heart defects in the fetus ranged 28.36±5.08. The weight of women with isolated heart defects in the fetus averaged 70.26±10.09, the height of pregnant women corresponded to 164.86±5.39 cm. In 73% of cases pregnant women were referred to the obstetric hospital by cardiologists, ultrasound specialists and in 27% by obstetricians-gynecologists on an outpatient basis. The average gestational age at which the fetus was first detected by ultrasound was isolated from 22.23±5.04 weeks. The total number of ultrasounds in pregnant women with congenital heart defects in the fetus was 4.80±0.92 times. In 54% of cases women had first pregnancy. 

Conclusions. Congenital heart defects are not directly dependent on the age of the pregnant woman and her anthropometric data. For the first time, isolated congenital heart defects were determined in second trimester of pregnancy (22 weeks). Considering multifactorial etiology of congenital heart defects, there is a need in a further study of this problem using multidisciplinary approach in diagnosis.  

https://doi.org/10.32345/2664-4738.4.2021.08
Article PDF (Українська)

References

Su W, Zhu P, Wang R, Wu Q, Wang M, Zhang X, Mei L, Tang J, Kumar M, Wang X, Su L, Dong N. Congenital heart diseasesand their assosiatrion with the variant distribution features on susceptibility genes. Clin. Genet. 2017;91(3): 349-354. DOI: 10.1111/cge.12835.

View at:

Publisher Site: https://onlinelibrary.wiley.com/doi/10.1111/cge.12835

PubMed: https://pubmed.ncbi.nlm.nih.gov/27426723/

Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, Haase N, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O'Donnell Ch, Roger V, Rumsfeld J, Sorlie P, Steinberger J, Thom T, Wasserthiel-Smoller S, Hong Y. Heart disease and stroke statistics-2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115(5):e69-e171. DOI: 10.1161/CIRCULATIONAHA.106.179918.

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.106.179918

PubMed: https://pubmed.ncbi.nlm.nih.gov/17194875/

Krasuski RA, Bashore TM. Congenital heart disease epidemiology in the United States: blindly feeling for the charging elephant. Circulation. 2016;134(2)110-113. DOI: 10.1161/CIRCULATIONAHA.116.023370.

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.116.023370

PubMed: https://pubmed.ncbi.nlm.nih.gov/27382106/

Shargorodska Ye. Сongenital diseases of the heart among newborn children: genetic aspects. The Journal of V. N. Karazin Kharkiv National University, series "Medicine". 2019; 38: 79-95. DOI: 10.26565/2313-6693-2019-38-10. [in Ukrainian]

View at:

Publisher Site: https://periodicals.karazin.ua/medicine/article/view/14349

URL: https://periodicals.karazin.ua/medicine/article/view/14349/13715

Marelli AJ, Ionescu-Ittu R, Mackie AS, Guo L, Dendukuri N, Kaouache M. Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Circulation. 2014; 130(9):749-56. DOI: 10.1161/CIRCULATIONAHA.113.008396.

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.113.008396

PubMed: https://pubmed.ncbi.nlm.nih.gov/24944314/

Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 Update: a report from the American Heart Association. Circulation. 2016;133(4):e38-360. DOI: 10.1161/CIR.0000000000000350

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000350

PubMed: https://pubmed.ncbi.nlm.nih.gov/26673558/

Rossberg N, Stangl K, Stangl V. Pregnancy and cardiovascular risk: A review focused on women with heart disease undergoing fertility treatment. Eur J Prev Cardiol. 2016; 23(18):1953-1961. DOI: 10.1177/2047487316673143.

View at:

Publisher Site: https://academic.oup.com/eurjpc/article/23/18/1953/5919089

PubMed: https://pubmed.ncbi.nlm.nih.gov/27798362/

Warrington NM, Beaumont RN, Horikoshi M. et al. Maternal and fetal genetic effects on birth weight and their relevance to cardio-metabolic risk factors. Nature Genetics. 2019;51(5):804-814. DOI: 10.1038/s41588-019-0403-1.

View at:

Publisher Site: https://www.nature.com/articles/s41588-019-0403-1

PubMed: https://pubmed.ncbi.nlm.nih.gov/31043758/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522365/

Pierpont ME, Brueckner M, Chung WK. et al. Genetic Basis for Congenital Heart Disease: Revisited: A Scientific Statement From the American Heart Association. Circulation. 2018; 138(21):e653-e711. DOI: 10.1161/CIR.0000000000000606.

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000606

PubMed: https://pubmed.ncbi.nlm.nih.gov/30571578/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555769/

Rudaeva EV, Mozes VG, Kashtalap VV, Zakharov IS, Yelgina SI, Rudaeva EG. Congenital heart disease and pregnancy. Fundamental and Clinical Medicine. 2019;4(3):102-112. DOI: 10.23946/2500-0764-2019-4-3-102-112. [in Russian]

View at:

Publisher Site: https://fcm.kemsmu.ru/jour/article/view/167

Saito Yo. The role of the PlGF/Flt-1 signaling pathway in the cardiorenal connection. Journal of Molecular and Cellular Cardiology. 2021; 151:106-112. DOI: 10.1016/j.yjmcc.2020.10.001.

View at:

Publisher Site: https://www.jmcc-online.com/article/S0022-2828(20)30295-9/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/33045252/

Fung A, Manlhiot C, Naik S, Rosenberg H, Smythe J, Lougheed J, Mondal T, Chitayat D, McCrindle BW, Mital S. Impact of Prenatal Risk Factors on Congenital Heart Disease in the Current Era. J Am Heart Assoc. 2013;2(3): e000064. DOI: 10.1161/JAHA.113.000064.

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/JAHA.113.000064

PubMed: https://pubmed.ncbi.nlm.nih.gov/23727699/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698764/

Zaidi S, Brueckner M. Genetics and Genomics of Congenital Heart Disease. Circulation Research. 2017;120(6):923-940. DOI: 10.1161/CIRCRESAHA.116.309140

View at:

Publisher Site: https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.116.309140

PubMed: https://pubmed.ncbi.nlm.nih.gov/28302740/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557504/

Yanqiu Ou, Jinzhuang, Zhuang J, Liu X, Wu Y, Gao X, Nie Z, Qu Y, Chen J, Kielb C, Lauper U, Lin S. Risk factors of different congenital heart defects in Guangdong, China. Pediatric research. 2016; 79(4): 549-558. DOI: 10.1038/pr.2015.264.

View at:

Publisher Site: https://www.nature.com/articles/pr2015264

PubMed: https://pubmed.ncbi.nlm.nih.gov/26679154/

Binder J, Carta S, Carvalho JS, Kalafat E, Khalil A, Thilaganathan B. Evidence for uteroplacental malperfusion in fetuses with major congenital heart defects. PLoS One. 2020;15(2):e0226741. DOI: 10.1371/journal.pone.0226741

View at:

Publisher Site: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226741

PubMed: https://pubmed.ncbi.nlm.nih.gov/32023263/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001956/

Fantasia I, Andrade W, Syngelaki A, Akolekar R, Nicolaides KH. Impaired placental perfusion and major fetal cardiac defects. Ultrasounds in Obstetrics & Gynecology. 2019;53(1):68-72. DOI: 10.1002/uog.20149

View at:

Publisher Site: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.20149

Bakker AB, Du D, Derks D. Major life events in family life, work engagement, and performance: A test of the work-home resources model. International Journal of Stress Management. 2019; 26(3): 238-249. DOI: 10.1037/STR0000108

View at:

Publisher Site: https://psycnet.apa.org/record/2018-33715-001

Camm EJ, Botting KJ, Sferruzzi-Perri FN. Near to One's Heart: The Intimate Relationship Between the Placenta and Fetal Heart. Frontiers in Physiology. 2018;9:e629. DOI: 10.3389/fphys.2018.00629

View at:

Publisher Site: https://www.frontiersin.org/articles/10.3389/fphys.2018.00629/full

PubMed: https://pubmed.ncbi.nlm.nih.gov/29997513/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029139/

Draker N, Torry DS, Torry RJ. Placenta growth factor and sFlt-1 as biomarkers in ischemic heart disease and heart failure: a review. Biomarkers in Medicine. 2019;13(9):785-799. DOI: 10.2217/bmm-2018-0492

View at:

Publisher Site: https://www.futuremedicine.com/doi/10.2217/bmm-2018-0492

PubMed: https://pubmed.ncbi.nlm.nih.gov/31157982/

Timchenko OI, Linchak OV, Procyuk OV, Mikitenko DA, Omel'chenko M, Pokanevich TM, Galagan VA, Pol'ka EA, Sizonenko OV, Maksiian OI, Kachko GA, Pozmogova NV, Pedan LR. Prevalence and risk factors for congenital malformations of newborns in Ukraine. Russian Bulletin of the Obstetrician-Gynecologist. 2014; 14(4):39-43 [in Ukrainian].

View at:

Publisher Site: https://www.mediasphera.ru/issues/rossijskij-vestnik-akushera-ginekologa/2014/4/031726-6122201448

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