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Persistently low cardiac output predicts high mortality in newborns with cardiogenic shock.

Persistently low cardiac output predicts high mortality in newborns with cardiogenic shock.

Neonatal Intensive Care Unit, University of Chieti, Italy.

Panminerva medica (Impact Factor: 0.98). 03/1998; 40(1):28-32.

Source: PubMed

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ABSTRACT Cardiogenic shock is an acute “unstable” state of circulatory dysfunction.
To evaluate the haemodynamic aspects of 45 newborn infants affected by cardiogenic shock, in relation to etiologies and the mortality rate.
Retrospective, correlation study of etiologies, mortality rate and haemodynamic measurements by Doppler ultrasound parameters.
45 newborn infants with cardiogenic shock, Gestational Age (GA) 37 (34-41), Birth Weight (BW) 2750 (1600-3600) g and and a control group of 20 neonates [GA 38 (34-40) wks, BW 2960 (1750-3800) g].
Left ventricular Cardiac Output (CO) was measured by a duplex scanner with pulsed Doppler and color flow mapping echocardiography in the first 48 hours of life.
In healthy newborns CO was 240 mL/min/kg (210-280), in newborns with cardiogenic shock CO was 170 mL/min/kg (f130-200), p < 0.01. The Stroke Volume was 1.80 mL/kg (1.70-1.90) in the control group and 1.20 (1.15-1.80) in the shocked group (p < 0.05); Heart Rate was 146 beats/min (130-160) and 160 beats/mm (140-194), (p < 0.01) respectively. Twenty-nine infants with cardiogenic shock had CO < or = 150 mL/min/kg and 5 of them (17.2%) died; 16 neonates had CO > 150 mL/min/kg and only one (6.2%) died (p < .01). Twenty-six of 36 newborns with perinatal asphyxia had CO < or = mL/min/kg and 5 of them died, while only one of 10 infants with CO > 150 mL/min/kg died.
Our results show that persistently low CO (< or = mL/min/kg) during the first 48 hours life, in newborns with cardiogenic shock due to perinatal asphyxia is associated with a significantly higher mortality.

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Prenatal diagnosis of interrupted inferior vena cava as an isolated finding: a benign vascular malformation.

Prenatal diagnosis of interrupted inferior vena cava as an isolated finding: a benign vascular malformation.

C Celentano, G Malinger, S Rotmensch, S Gerboni, Y Wolman, M Glezerman
Department of Obstetrics, Edith Wolfson Medical Center, Holon, Israel.
Ultrasound in Obstetrics and Gynecology (Impact Factor: 3.56). 10/1999; 14(3):215-8. DOI:10.1046/j.1469-0705.1999.14030215.x
Source: PubMed
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ABSTRACT We report two cases of interrupted inferior vena cava with azygous continuation diagnosed as an isolated finding during routine prenatal scans. Visualization of the venous vasculature of the abdomen and thorax in the mid-sagittal plane failed to visualize the segment of the inferior vena cava between the kidneys and the liver. A vessel with venous flow was observed parallel, adjacent and posterior to the aorta between the kidney and the right atrium. This blood vessel connected with the superior vena cava. Axial planes of the thorax confirmed the presence of two vessels running paravertebrally. A detailed ultrasound examination of the fetal anatomy failed to demonstrate other anomalies. The neonatal course of both fetuses was uneventful. Isolated interruption of the inferior uena cava can be a vascular malformation without known pathological consequences.

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Prenatal Evaluation and Management of Fetuses Exposed to Anti-SSA/Ro Antibodies

REVIEW ARTICLE
Pediatr Cardiol (2012) 33:1245–1252

Prenatal Evaluation and Management of Fetuses Exposed
to Anti-SSA/Ro Antibodies
Anita Krishnan Jodi I. Pike Mary T. Donofrio

Received: 23 February 2012 / Accepted: 29 April 2012 / Published online: 22 May 2012
Springer Science+Business Media, LLC 2012
Abstract
Maternal anti-SSA antibodies are common, existing in up to 2 % of the general population. Fetuses
exposed to these antibodies are at risk for both cardiac and noncardiac complications. The cardiac complications
include arrhythmias, structural disease, and cardiomyopathy. Although rare, the cardiac disease associated with these
antibodies is permanent and severe. Current fetal echocardiographic screening tools are nonspecific. The type and
frequency of screening needed is controversial. Although promising transplacental treatment strategies exist, pro-
spective randomized studies are lacking. Dexamethasone, the medication used most frequently, imposes significant
risks to both mother and fetus. This report presents a discussion of the at-risk population, the spectrum of fetal
cardiac disease associated with maternal anti-SSA antibodies, the current fetal echocardiographic screening tools,
the therapeutic options, and the management and delivery planning strategies. With appropriate prenatal follow-up,
assessment, and delivery planning, even high-risk fetuses can be delivered safely and managed effectively.

Pediatr Cardiol (2012) 33:1245–1252

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Echocardiographic observation and clinical significance of echogenic intracardiac foci in 310 fetuses

23rd World Congress on Ultrasound in Obstetrics and Gynecology

Echocardiographic observation and clinical significance
of echogenic intracardiac foci in 310 fetuses
Y. He, Y. Guo, Y. Zhang, J. Han, Z. Li
Beijing Anzhen Hospital Capital Medical University, Beijing,
China
Objectives:
To assess the clinical meaning of echogenic intracardiac
focus in fetuses by echocardiography.

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Echogenic focus in the fetal left ventricular cavity: Is it a false tendon?

neologoEchogenic focus in the fetal left ventricular cavity: Is it a false tendon?
Nahide Altug a*, A. Nuri Danisman b*
a* Zekai Tahir Burak Maternity Teaching Hospital, Ped. Cardiology Unit, Ankara, Turkey
b* Zekai Tahir Burak Maternity Teaching Hospital, Perinatology Unit, Ankara, Turkey

Early Human Development, Volume 89, Issue 7, July 2013, Pages 479-482

abstract

Keywords: Fetus, False tendon,Echogenic focus,Fetal echocardiography
Objective:
To draw attention to the left ventricular false tendon which can be misinterpreted as echogenic focus in the fetus.
Methods:
The study group consisted of 9 fetuses out of the 161 who had been misdiagnosed for left ventricular false tendon as echogenic focus by obstetricians. Fetal echocardiography and 2-D color Doppler echocardiography were performed in the pre-postnatal period. The standard fetal echocardiographic views (4,5 chamber views, long axis view of the left ventricle, short axis view of the ventricles and great arteries, three vessels and trachea view, long axis views of the duct and aortic arch) were obtained for each case.

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Echocardiographic observation and clinical significance of echogenic intracardiac foci

23rd World Congress on Ultrasound in Obstetrics and Gynecology

Echocardiographic observation and clinical significance
of echogenic intracardiac foci in 310 fetuses
Y. He, Y. Guo, Y. Zhang, J. Han, Z. Li
Beijing Anzhen Hospital Capital Medical University, Beijing,
China
Objectives:
To assess the clinical meaning of echogenic intracardiac
focus in fetuses by echocardiography.
Methods:
The data of 310 fetuses diagnosed as echogenic
intracardiac focus by echocardiography were reviewed. The
ultrasonic characters and clinical data were analysed.
Results:
310 fetuses were all nature pregnancies, and pregnancies
with high risk factors was 41 cases. The solitary EIF cases in left
ventricle were 263 (85% ). The solitary EIF cases in right ventricle
were 1 (3‰). The multiple EIF cases in left ventricle were 44 (14%).
The multiple EIF cases in both ventricles was 2 (6‰). The incidence
of congenital heart disease in the EIF group was 19‰ (6 cases) and
there was no significant difference between the EIF group and the
normal group. Down syndrome cases were 2 (6‰) both of them were
in the high risks group (elderly pregnant woman) 5 women stopped
pregnancy because of fetal malformation. Among the remaining
cases EIF gradually became pale, smaller or disappeared in 281cases
(92%) and 299 (96%) isolated EIF cases had a good clinical outcome
after birth.
Conclusions:
The isolated EIF in fetal heart without complicating
any other abnormalities has no significant clinical meaning. There
were no relationship between the isolated EIF fetal chromosome
abnormality and congenital heart disease

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48th Annual Meeting of the Association for European Paediatric and Congenital Cardiology

It is our pleasure to invite you to the 48th Annual Meeting of the Association for European Paediatric and Congenital Cardiology, which will be held in Helsinki on 21-24 May 2014. We are pleased to organise the Annual Meeting for the second time in Helsinki after the 1966 AEPC meeting.

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Prenatal Evaluation and Management of Fetuses Exposed to Anti-SSA/Ro Antibodies

REVIEW ARTICLE
Pediatr Cardiol (2012) 33:1245–1252

Prenatal Evaluation and Management of Fetuses Exposed
to Anti-SSA/Ro Antibodies
Anita Krishnan Jodi I. Pike Mary T. Donofrio

Received: 23 February 2012 / Accepted: 29 April 2012 / Published online: 22 May 2012
Springer Science+Business Media, LLC 2012
Abstract
Maternal anti-SSA antibodies are common, existing in up to 2 % of the general population. Fetuses
exposed to these antibodies are at risk for both cardiac and noncardiac complications. The cardiac complications
include arrhythmias, structural disease, and cardiomyopathy. Although rare, the cardiac disease associated with these
antibodies is permanent and severe. Current fetal echocardiographic screening tools are nonspecific. The type and
frequency of screening needed is controversial. Although promising transplacental treatment strategies exist, pro-
spective randomized studies are lacking. Dexamethasone, the medication used most frequently, imposes significant
risks to both mother and fetus. This report presents a discussion of the at-risk population, the spectrum of fetal
cardiac disease associated with maternal anti-SSA antibodies, the current fetal echocardiographic screening tools,
the therapeutic options, and the management and delivery planning strategies. With appropriate prenatal follow-up,
assessment, and delivery planning, even high-risk fetuses can be delivered safely and managed effectively.

Pediatr Cardiol (2012) 33:1245–1252

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