Counseling and outcomes of antenatally diagnosed congenital heart anomalies in Turkey
Counseling and outcomes of antenatally diagnosed congenital heart anomalies in Turkey
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DOI：
10.5152/akd.2011.035
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发表时间：
2011-03-01
影响因子：
1.3
通讯作者：
Ceylan, Yavuz
中科院分区：
文献类型：
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作者：
Gedikbasi, Ali;Oztarhan, Kazim;Ceylan, Yavuz
目的：方法：对155例产前诊断为先天性心脏病的胎儿按Allan-Huggon分级系统进行回顾性分类：A组（n=155），B组（n=155），C组（n=155），D组（n =155），（与重度/致死性心外疾病相关的心脏病）; B1组B1组（低风险，出生后预后）; B2组（中等风险，适合手术修复，死亡率低）;和B3组（高风险，与手术后高死亡率相关）。新生儿的结果，包括终止妊娠，记录了18个月的后续咨询后的父母。采用Student t检验、Mann-Whitney U检验、Pearson卡方检验和Fischer精确卡方检验进行统计学分析。39例病例（A组）与心外致死性缺陷相关，妊娠终止;这些病例从统计学评价中排除。B3组的20名家长也选择了终止。三个心脏异常组（B1组，n=37; B2组，n=12;和133组，n=37）之间随访18个月后继续妊娠的存活率分别为89.2%、66.7%和13.5%。三组的生存率之间存在显著性[B3组与B1组：p=0.0001; OR：52.8（12.9-214.5）; B3组与B2组：p=0.0009; OR：12.8（2.8-58.9）; B2组与B1组：p=0.087; OR：4.12（0.84-20.2）]结论：我们的实践和本文报道的发现支持该分期系统的有效性，并为胎儿先天性心脏病的父母提供咨询。（Anadolu Kardiyol贝格2011; 11：137-45）
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 133, 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. (Anadolu Kardiyol Berg 2011; 11: 137-45)