ultrasound diagnosis of fatal anomalies

COARCTATION OF THE AORTA
5. In cases of severe cardiac anomalies, the
patient may opt for termination of the pregnancy.
From our point of view, it is very important
that after counseling, this decision comes
solely from the patient (nondirective counseling)and
that she should not be rushed into
taking a decision because of lack of time (in Germany,
there is no gestation limit for a medical indication
for the termination of pregnancy at
present). Psychotherapeutic sessions should
also be offered to the parents.
6. Detecting a cardiac anomaly does not necessarily
alter the plan of antenatal care or the
method of delivery. Usually, a normal delivery
can be expected at due date. However, the pregnancy
must be monitored more often using ultrasonography.
7. The presence of a cardiac anomaly does not
always mean delivery by cesarean section, but
the delivery should take place in a center in
which a pediatric intensive-care unit as well as
an experienced pediatric cardiology team are
available. After birth, the cardiologist performs
an echocardiography and decides which other
measures are immediately necessary. Anomalies
such as ventricular septal defect or atrial septal
defect do not always have to be treated, as many
resolve spontaneously within the first year of
life.
The advantages of fetal echocardiography can
be summarized as follows:
1. The main advantage of routine fetal echocardiography
during pregnancy is to dispel any
fear of having cardiac anomalies when the fetal
ultrasound screening is normal.
Coarctation of the Aorta
Definition: Narrowing of the aorta over a variable
distance near the junction of ductus arteriosus
(Botallo’s duct).
Incidence: One in 1600 births.
Sex ratio: M:F=1.5:1.
Clinical history/genetics: Multifactorial inheritance;
risk of recurrence with one affected child
2%, with two affected children 6%; if the mother
is affected, then the risk of recurrence rises to
18%, in case of an affected father it is 5%.
2. If a severe cardiac anomaly is diagnosed or
cardiac malformation suggests genetic disease,
the parents have the option of whether or not to
carry on with the pregnancy.
3. If the mother decides to carry on with the
pregnancy after diagnosis of a fetal cardiac
anomaly, the prenatal diagnosis allows optimal
monitoring of the pregnancy, labor, delivery, and
neonatal care of the child, which otherwise
might have had a very poor chance of surviving,
if any.
Information for the Mother of an Affected Fetus
Title: CHASER (Congenital Heart Anomalies—
Support, Education, Resources)
Description: Opportunity for parents of
children born with heart defects to network
with other parents with similar needs and
concerns. Education on hospitalization,
surgeries, medical treatments, etc. Newsletter,
information and referral, phone support.
Heart surgeons and facilities directory.
Scope: National
Founded: 1992
Address: 2112 N. Wilkins Rd., Swanton, OH
43558, United States
Telephone: 419–825–5575 (day)
Fax: 419–825–2880
E-mail: chaser@compuserve.com
Web:
chaser/
http://www.csun.edu/~hfmth006/
Teratogens: Diabetes mellitus, high doses of vitamin
A.
Associated malformations: Other cardiac
anomalies such as VSD, valvular aortic stenosis,
transposition of the great arteries.
Associated syndromes: Turner syndrome (35%
of affected children have coarctation of the
aorta). This vessel anomaly has also been described
in over 25 different syndromes.
Ultrasound findings: Asymmetrical heart chambers
with dilation of the right heart (atrium, ven-
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