ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Counseling and outcomes of antenatally diagnosed congenital heart anomalies in Turkey [Anatol J Cardiol]
Anatol J Cardiol. 2011; 11(2): 137-145 | DOI: 10.5152/akd.2011.035

Counseling and outcomes of antenatally diagnosed congenital heart anomalies in Turkey

Ali Gedikbaşı1, Kazım Öztarhan2, Gökhan Yıldırım1, Ahmet Gül1, Yavuz Ceylan1
1Clinic of Obstetrics and Gynecology, İstanbul Bakırköy Maternity and Children Diseases Hospital, İstanbul, Turkey
2Bakırköy Doğumevi, Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Pediatrik Kardiyoloji Bölümü, İstanbul, Türkiye

Objective: To determine the clinical outcomes and decisions of families of fetuses with prenatally-diagnosed cardiac abnormalities. Methods: Prenatally diagnosed cases (n=155) with congenital heart disease were retrospectively categorized according to the Allan-Huggon grading system: Group A (cardiac disease associated with severe / lethal extracardiac disease); Group B1 (low risk with a postnatal prognosis); Group B2 (moderate risk, amenable to surgical repair with a low mortality); and Group B3 (high risk, associated with high mortality after surgery). Neonatal outcomes, including termination of pregnancy, were recorded for 18 months of follow-up after counseling the parents. Student’s t-test, Mann-Whitney U, Pearson’s Chi-square test and Fischer’s exact Chi-square test were used for statistical analyses. Results: One hundred forty-five cases completed follow up. Thirty-nine cases (Group A) were associated with extracardiac lethal defects and the pregnancies were terminated; these cases were excluded from statistical evaluation. Twenty parents in Group B3 opted also for termination. The survival rates of ongoing pregnancies after 18 months of follow-up between the three cardiac abnormality Groups (Group B1, n=37; Group B2, n=12; and Group B3, n=37) were 89.2%, 66.7%, and 13.5%, respectively. Significance was present between the survival rates of the three Groups [Group B3 vs. Group B1: p=0.0001; OR: 52.8 (12.9-214.5); Group B3 vs. Group B2: p=0.0009; OR: 12.8 (2.8-58.9); Group B2 vs. Group B1: p=0.087; OR: 4.12 (0.84-20.2)]. Conclusion: Our practice and the findings reported herein support the efficacy of this staging system and counseling parents of fetuses for congenital heart diseases.

Keywords: Congenital heart defects, counseling, outcome, extracardiac malformations, ultrasound, fetal echocardiography

Ali Gedikbaşı, Kazım Öztarhan, Gökhan Yıldırım, Ahmet Gül, Yavuz Ceylan. Counseling and outcomes of antenatally diagnosed congenital heart anomalies in Turkey. Anatol J Cardiol. 2011; 11(2): 137-145
Manuscript Language: English

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