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a Chapter 35 Doppler Echocardiographic Assessment of Fetal Cardiac Failure 527<br />

Table 35.4 (continued)<br />

Neoplastic<br />

Neuroblastoma<br />

Teratoma<br />

Sacral<br />

Mediastinal<br />

Malignant<br />

Congenital leukemia with Down syndrome<br />

Hemangioendothelioma of the liver<br />

Pulmonary leiomyosarcoma<br />

Tuberous sclerosis<br />

Cardiovascular<br />

Cardiac structure<br />

Atrioventricular canal defect<br />

With abdominal situs inversus and complete heart<br />

block<br />

With transposition of great arteries<br />

With transposition of the great vessels and asplenia<br />

With transposition of the great vessels and polysplenia<br />

With double-outlet right ventricle and pulmonic stenosis<br />

With overriding aorta, tracheoesophageal fistula<br />

With complex bradyarrhythmia, atrioventricular (AV)<br />

valve insufficiency, interrupted inferior vena cava<br />

Complete communication with common AVvalve<br />

Tetralogy of Fallot<br />

Absent pulmonary valve or pulmonary atresia<br />

Aortic atresia, diminutive left ventricle, and mitral<br />

valve<br />

Aortic valve stenosis with mitral insufficiency<br />

Aortic arch interruption<br />

Tricuspid dysplasia and Ebstein's anomaly<br />

Tricuspid and pulmonary atresia<br />

Myocardial infarction with coronary artery embolus<br />

Intrapericardial teratoma<br />

Cardiac rhabdomyoma<br />

Myocardial tumors involving ventricular septum, aortic<br />

outflow, and left atrium, not requiring surgery<br />

Intrauterine closure of foramen ovale<br />

Intrauterine closure of ductus arteriosus<br />

Endocardial fibroelastosis<br />

With mitral valve insufficiency<br />

With subaortic stenosis<br />

Ventricular septal defect<br />

With atrial septal defect (ASD)<br />

With ASD and right atrial conduction system hamartoma<br />

With patent ductus arteriosus with absent right<br />

hemidiaphragm<br />

Cardiac rhythm<br />

Atrial<br />

Bradycardia and bradyarrhythmia<br />

Tachycardia<br />

Paroxysmal<br />

Wolff-Parkinson-White syndrome<br />

Flutter with block<br />

Complete heart block<br />

Table 35.4 (continued)<br />

Vascular<br />

Vena cava thrombosis<br />

Hemangioendothelioma<br />

Arterial calcification<br />

Arteriovenous malformation<br />

Cerebral angioma<br />

Metabolic<br />

Gaucher's disease<br />

Sialidosis<br />

Gangliosidosis GM1<br />

Mucopolysaccharidosis<br />

Skeletal dysplasias<br />

Achondroplasia<br />

Achondrogenesis<br />

Parenti-Fraccaro (or type I)<br />

Langer-Saldino (or type II)<br />

Osteogenesis imperfecta<br />

Thanatophoric dwarfism<br />

Short rib-polydactyly syndrome<br />

Saldino-Noonan type<br />

Majewski type<br />

Asphyxiating thoracic dysplasia<br />

Chromosomal<br />

Triploidy<br />

Trisomies<br />

13<br />

21 (Down's syndrome)<br />

18 (Edward's syndrome)<br />

47XY+der, t(11:21)(q23:q11) mat<br />

Abnormal chromosome 11<br />

Mosaic 46XX/XY<br />

Mosaic 46XY/92XXYY<br />

45XO (Turner's syndrome)<br />

dup (11p)<br />

Hereditary<br />

Pena-Shokeir type I<br />

Lethal multiple pterygium syndrome<br />

Noonan syndrome with congenital heart defect<br />

Placental<br />

Chorioangioma<br />

Although primary fetal heart failure can be a cause of<br />

non-immune fetal hydrops, heart failure secondary to<br />

other causes, such as anemia, hypoproteinemia, or<br />

hypoxia, may be a more common etiology of the<br />

problem. Many of these postulated causes of non-immune<br />

fetal hydrops are analogous to some of the<br />

causes of heart failure in the adult.<br />

Isoimmunization<br />

Isoimmunization in the fetus (usually as a result of<br />

Rh incompatibility) results in a progressive destruction<br />

of fetal red cells and fetal anemia [59]. Doppler<br />

studies have shown that both left and right cardiac<br />

outputs are significantly higher than normal in anemic<br />

fetuses, with a significant increase in volume<br />

flow, peak velocity in the outflow tracts, and an de-

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