ABSTRACT
BACKGROUND: Congenital heart disease is often severe and outcome remains uncertain. In some cases, early intervention at birth can improve the prognosis. Prenatal detection of congenital heart disease by ultrasound may improve outcome for foetuses with congenital heart disease but today, results are not convincing. The purpose of this review was to describe the detection of congenital heart disease in a non selected population. METHODS: A retrospective study was undertaken to evaluate the prenatal detection of congenital heart disease in our department from 1984 to 2003. RESULTS: Incidence of congenital heart disease was 4.9. Sensitivity of detection was 60%, specificity was 99.9%. Most cases were severe heart diseases. In 57 fetuses (40%), congenital heart disease was not detected. Thirty-seven fetuses (65%) presented minor disease; in 20 fetuses (35%), congenital heart disease was found to be severe. Effectiveness of detection of major congenital heart diseases has increased since 2000. CONCLUSION: Large-scale fetal heart screening is necessary for early detection of congenital heart disease and improved outcome.
Subject(s)
Heart Defects, Congenital/diagnosis , Female , Humans , Infant, Newborn , Predictive Value of Tests , Pregnancy , Prenatal Diagnosis , Retrospective Studies , Sensitivity and SpecificityABSTRACT
OBJECTIVES: Evaluation of amnioinfusion results during labour in case of thick meconial amniotic fluid or in case of oligo-hydramnios associated with variable deceleration of the fetal heart response. PATIENTS AND METHODS: Prospective non randomized study. Amnioinfusion was applied to 47 cases of thick meconial amniotic fluid and to 18 cases of variable fetal heart decelerations associated with oligo-hydramnios. Obstetrical and neonatal data were compared with a similar group without amnioinfusion (n = 32). RESULTS: Comparing both groups shows that amnioinfusion offers a better fetal well-being during labour, according to Kreb's fetal heart evaluation during labour (8.53 +/- 1.06 vs 6.56 +/- 0.35--p < 0.01), lows the cesarean section rate (8.5% vs 31.2%--p < 0.01). Amnioinfusion is also associated with a higher Apgar's score at one minute after delivery (9.4 +/- 0.8 vs 8.7 +/- 1.7--p = 0.01) and a lower rate of thick meconium inhalation (13.7% vs 40.7%--p < 0.01). There was no difference for children's first days of life. We found no serious complication following amnioinfusion. CONCLUSION: We confirm general agreement about amnioinfusion, according to international literature. Amnioinfusion needs an acute care to prevent classically described complications. In case of thick meconial amniotic fluid or variable decelerations associated with oligo-hydramnios, amnioinfusion during labour offers a better fetal well-being.
Subject(s)
Amnion , Amniotic Fluid/physiology , Fluid Therapy , Obstetric Labor Complications/therapy , Adult , Female , Humans , Pregnancy , Prospective StudiesABSTRACT
This report describes a prenatal diagnosis of intraspinal lipoma. This pathology, not well known by obstetricians, forms a part of neural tube defects. Echographic aspect, embryologic origin, differential diagnosis, neurosurgical prognosis and treatment are reviewed and discussed.
