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Isolated premature restriction or closure of foramen ovale in fetuses: Echocardiographic characteristics and outcome
Journal article   Peer reviewed

Isolated premature restriction or closure of foramen ovale in fetuses: Echocardiographic characteristics and outcome

Xiaoyan Gu, Ye Zhang, Jiancheng Han, Xiaowei Liu, Shuping Ge and Yihua He
Echocardiography (Mount Kisco, N.Y.), v 35(8), pp 1189-1195
Aug 2018
DOI: https://doi.org/10.1111/echo.14009
PMID: 29756643
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Adult Echocardiography, Doppler, Pulsed - methods Female Fetal Heart - diagnostic imaging Fetal Heart - physiopathology Follow-Up Studies Foramen Ovale - diagnostic imaging Foramen Ovale - embryology Heart Atria - diagnostic imaging Heart Atria - embryology Heart Atria - physiopathology Heart Defects, Congenital - diagnosis Heart Defects, Congenital - embryology Heart Defects, Congenital - physiopathology Heart Ventricles - diagnostic imaging Heart Ventricles - embryology Heart Ventricles - physiopathology Humans Pregnancy Pregnancy Outcome Retrospective Studies Ultrasonography, Prenatal - methods Young Adult
Premature restriction or closure of foramen ovale (FO) in otherwise structurally normal hearts may be associated with right ventricular dilation, tricuspid regurgitation, pericardial effusion, heart failure, even poor perinatal outcomes. Data about these rare conditions are lacking. We retrospectively reviewed the echocardiographic records of 9704 fetuses seen from 2010 to 2014 in Beijing Anzhen Hospital, a regional and national referral center, to ascertain the presence of restriction or closure of FO. We collected the fetal echocardiography and perinatal outcome data for this group of fetuses with restriction or closure of FO. In this large, single-institution cohort (n = 9704), 6707 fetuses seen between 23 and 37 weeks of gestation had normal heart structures; of these, 60 (0.89%) had restrictive FO (rFO) and 5 (0.07%) had closure of FO (cFO). Fetal echocardiographic images showed right atrial dilation in 48 (73.84%), right ventricular dilation in 38 (58.46%), tricuspid regurgitation in 19 (29.23%), and pericardial effusion in 10 (15.38%). Also in this group, 50 (83.3%) with rFO and 4 (80.0%) with cFO had follow-up data. No prenatal deaths occurred in either the rFO or the cFO group, but the neonatal mortality included 1 in the rFO group and 2 in the cFO group. Premature rFO/cFO are rare in fetuses with otherwise structurally normal hearts. The fetal echocardiographic characteristics include right atrial and ventricular dilated, tricuspid regurgitation, and pericardial effusion. Most fetuses had a good outcome, although there was an association between rFO, especially cFO, with neonatal morality and complications (prematurity, maternal preeclampsia and placental abruption, hydrops fetalis, and necrotizing enterocolitis with perforation).

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20 citations in Web of Science
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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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