2009 Southern Regional Meeting Abstracts

Purpose of Study: Fetal ultrasounds with anatomic correlation
Methods Used: Clinical studies
Summary of Results: Case 1. At 20 weeks gestation a female fetus presented with poor left ventricular(LV) function. Progressive enlargement of the LV with the development of Endocardial Fibroelastosis(EFE) and eventual right ventricular enlargement ensued. Neonatal transplant was considered, but the family preferred compassionate care. The baby was born at term, weighing 3.32kg. The baby survived for 24 hours and died peacefully. Autopsy confirmed severe enlargement of the LV with thinning of the musculature and marked EFE. Serial sectioning of the left main coronary artery revealed occlusion with total fibrosis of the left anterior descending artery and the circumflex artery was very hypoplastic. The fetal echocardiogram and autopsy photos are presented
Case 2: At 22 weeks gestation a male fetus presented for cardiac ultrasound. The Aorta, the umbilical arteries and the coronary arteries were very bright, suggesting abnormal calcification. An intrauterine death occurred at 35 weeks and the baby was delivered the next day. At autopsy, the diagnosis of Idiopathic Arterial Calcification was made and slides of the ultrasound and microscopics of the arteries are presented.
Case 3 The cardiac diagnosis of Double-Outlet Right ventricle was made in a female infant who also developed intrauterine growth retardation. Mother declined amniocentesis. The baby girl was born at 37 weeks gestation with features of trisomy 18 and died on the 6th day of life. Ultrasound and autopsy photos are included in the presentation.
Case 4: A primagravida, 24 weeks pregnant with identical twins was referred for suspected cardiac abnormality in one twin. Severe Ebstein’s anomaly was present with associated fetal hydrops. Over time, the hydrops became severe. As the baby sickened, ultrasounds of the twin revealed elevated heart rate and accelerated breathing rates. The twin with Ebstein’s anomaly died at 30 weeks, and the surviving twin was delivered at 33 weeks without anomalies. The survivor was discharged after a 4 week neonatal ICU stay.
Conclusions: Even complex cardiac defects can be identified prenatally.