Effects of delivery classification scale for fetal cardiac disease on the prenatal and postnatal integrated treatment strategies
10.3760/cma.j.issn.1001-4497.2015.03.005
- VernacularTitle:胎儿先天性心脏病分娩风险分级在产前产后一体化诊治策略中的作用
- Author:
Chengbin ZHOU
;
Wei PAN
;
Shaoru HE
;
Fengzhen HAN
;
Xiaoqing LIU
;
Jimei CHEN
;
Jian ZHUANG
- Publication Type:Journal Article
- Keywords:
Fetus;
Congenital heart disease;
Delivery risk;
Treatment strategies
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2015;31(3):145-147
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effects of delivery classification scale for fetal cardiac disease on the prenatal and postnatal integrated treatment strategies.Methods Delivery classification scale for fetal cardiac disease included:grade Ⅰ,no hemodynamics instability; grade Ⅱ,ducted-dependent lesions,stable hemodynamics anticipated;grade Ⅲ,possibility or likelihood of hemodynamic instability; IMPACT(delivery immediately heart intervention) level,hemodynamic instability is anticipated at separation from placental circulation.During August 2006 to May 2010,a retrospective study of 46 cases of prenatal diagnosis of congenital heart disease and delivery in one cardiac center was taken,in which 33 in grade Ⅰ,9 in grade Ⅱ,4 in grade Ⅲ,and no IMPACT.Results Thirty-nine boys and 7 girls were born at (38.0 ± 1.4) weeks of gestation and had consistent fetal diagnoses of mainly cardiac abnormalities with postnatal screen.Thirteen neonates underwent cardiac intervention within one week after birth with one death,including 2 in grade Ⅰ,7 in grade Ⅱ,4 in grade Ⅲ,of them 1 death.Seven infants including 5 in grade Ⅰ and 2 in grade Ⅱ underwent cardiac intervention with one death.The remaining 26 children in grade Ⅰ had uneventfully outcomes,in which 7 cases of surgical operation,17 cases of interventional therapy,2 cases of spontaneous healing.Conclusion Delivery classification scale for fetal cardiac disease should have some guiding significance for early treatment strategies and could enhance closely integration of prenatal diagnosis and postnatal treatment.The most fetuses in grade Ⅰ need not undergo cardiac interventions in neonatal stage.However,early cardiac intervention for fetuses in grade Ⅱ and Ⅲ should be carried out postnatally with the help of neonatologists.
