ultrasound diagnosis of fatal anomalies

THE HEART
Fig. 5.4 Complete atrioventricular septal defect.
Same case. Slight tilting of the scanner produces almost
a normal appearance.
Fig. 5.5 Atrioventricular septal defect,
14+5weeks.Apical view of the four chambers using
color flow mapping.
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flow Doppler imaging, AV valvular incompetence
can often be detected. Disturbances in
stimulus conduction may lead to cardiac
arrhythmia (AV block, extrasystoles).
Clinical management: Further fetal ultrasound
screening. Karyotyping. Ultrasound monitoring
at regular intervals for early detection of cardiac
failure or fetal hydrops. Vaginal delivery is
possible.
Procedure after birth: Immediate postnatal
complications are not to be expected in the absence
of stenosis of great vessels. However, all
children require surgical correction, which is
usually carried out during the first year of life.
Initial symptoms develop at the age of 4–6
weeks after birth (tachypnea, tachycardia).
Prognosis: In most cases, it is possible to correct
the defect surgically. The perioperative mortality
is 5%. The prognosis becomes unfavorable if
obstruction of the pulmonary artery is also present.
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