ABSTRACT
The goal of the study was to assess the prognostic value of ultrasound finding of fetal cystic hygromas. Thirty cases of septated cystic hygromas were diagnosed at 10-15 weeks gestation by transabdominal ultrasound and followed through pregnancy. The rate of abnormal karyotype was found to be 61% and the global rate of unfavorable outcome, independently of karyotype result, as high as 96%. These data suggest that cautious genetic counselling should be offered when such cystic hygromas are noticed during the first 15 weeks of gestation, even with a normal karyotype.
Subject(s)
Chromosome Aberrations/statistics & numerical data , Congenital Abnormalities/epidemiology , Lymphangioma, Cystic/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Genetic Counseling , Humans , Karyotyping , Pregnancy , Pregnancy Outcome , Switzerland/epidemiologyABSTRACT
Cardiac arrhythmias are one of the most frequent indications for a 2D and Doppler fetal echocardiographic assessment (DE). If accompanied by a non-immune fetal hydrops, arrhythmias (A) involve an increased risk of intrauterine death. Some A and mainly the bradyarrhythmias (BA) can be the first sign of major cardiac malformation (CM). In a series of 404 pregnancies between week 17 and 40 of gestation (mean 27.6 weeks), a Doppler echocardiography was carried out; in 137 (35%) fetuses (F) this examination was based on the indication of arrhythmia. 33 (24.2%) of these fetuses showed a cardiac malformation. Bradyarrhythmias were found in 20 F; 5 had a complete AV-block including, 4 with an important cardiac abnormality (TU, complete AV-canal, corr. TGV). SVT's and auricular flutters (AF) made transplacental treatment necessary in 4 fetuses (1 AF, 3 SVT); they had no major cardiac malformation. PAC's were present in 59 pregnancies of which several had minor or major anomalies. Doppler echocardiography served to define the arrhythmia and the structural cardiac malformation, but also to follow transplacental treatment. These investigations have allowed us to schedule delivery under neonatal surveillance. After birth, 5 neonates had to be treated for persistent dysrhythmia (5 SVT, 2 complete AB-blocks), and 10 for a major cardiac malformation.