In Perinatal Cardiology, fetal cardiology experts provide key information on tools for fetal evaluation through echocardiography / cardiac ultrasonography, with a primary focus on the nature and prenatal detection of structural and functional cardiac heart defects (CHDs). In this two-part book, readers will find details about different types of fetal cardiac abnormalities along with important updates on the diagnosis, management, planning delivery, and postnatal treatment in CHD cases. This information is supplemented with guidelines for the clinical management of patients with a fetus affected by cardiovascular defects, and surgical procedures in neonates.
Key Features:
- Presents information gathered by experts in perinatal cardiology, organized into 26 topic-based chapters
- Explores the cardiac development, fetal cardiovascular hemodynamics, genetic and environmental factors associated with congenital heart defects (CHD), perinatal management, planning delivery, and postnatal treatment of newborns with CHD
- Presents information about normal cardiac functions and heart defects to give readers a clear and detailed picture of abnormal cardiac function
- Presents information about perinatal ultrasound physiology
- Gives practical guidelines for ultrasound and echography parameters required for evaluating fetal heart anatomy and diagnosing diseases
- Includes a new system of classifying prenatal CHDs based on the stratification of the risk level of care
- Features a straightforward and accessible style of presentation suitable for all readers
- Provides references in each chapter for further reading
Part 2 of this two-part set delves into different fetal anomalies such as ventricular inflow anomalies, myocardial and pericardial diseases, cardiac tumours, extra-cardiac conditions, cardiac failure, and environmental factors associated with CHD. The latter chapters cover clinical topics such as labour-management for patients bearing a child with CHD, fetal cardiac interventions, clinical management of neonates with CHD and postnatal surgery.
Perinatal Cardiology is an essential reference for postgraduate medical students seeking to improve their knowledge of fetal and pediatric cardiology as part of their residency and professional training. The book equips readers with the information necessary to understand the role of the perinatal cardiologist and goes further to facilitate the ability to perform adequate risk assessments for fetal CHD.
Table of Contents
Chapter 1 Fetal Ventricular Inflow Anomalies
- Nathalie J. Magioli Bravo-Valenzuela
- Introduction
- Univentricular Atrioventricular Connection
- Morphology
- Prenatal Diagnosis
- In Utero and Postnatal Management
- Atrioventricular Valves: Straddling and Overriding
- Crisscross Heart
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgement
- References
Chapter 2 Fetal Myocardial and Pericardial Diseases
- Ana B. Bianchi and Ihosvanny Gonzalez
- Introduction
- Fetal Heart Screening: Steps to Follow
- Definition
- Assessment of Cardiomegaly
- Growth of the Right and Left Atrium
- Ventricular Dilatations
- Other Causes
- Cardiac Tumors
- Fetal Cardiac Circulation
- Ultrasound Findings
- Hypertrophic Cardiomyopathies
- Definition of Strain: Definition of Strain Or Tension
- Ventricular Wall Aneurysms Or Diverticula
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 3 Fetal Cardiac Tumors
- Maria Respondek-Liberska
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
- Eliane Lucas, Carla Verona Barreto Farias and Nathalie Jeanne Magioli Bravo-
- Valenzuela
- Restricted Or Closed Foramen Ovale
- Restricted Or Closed Foramen Ovale with Structurally Normal Heart
- Restrictive Or Closed Foramen Ovale with Congenital Heart Disease
- Dextro – Transposition of the Great Arteries
- Hypoplastic Left Heart Syndrome with Restrictive Or Intact Atrial Septum
Chapter 4 Premature Closure of the Ductus Arteriosus
- Introduction
- Ductus Arteriosus- Embryology and Anatomy
- Mechanisms of Ductal Constriction and Hemodynamic Fetal Repercussions
- Ductal Constriction - Prenatal Diagnosis
- Ductal Constriction- Progression and Prenatal Management
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 5 Fetal Cardiac Dysfunction Related to Extra-Cardiac
- Conditions
- Filomena Sileo, Emma Bertucci and Francesco D’Antonio
- Pre and Post-Natal Circulation
- Ultrasound Assessment in Fetuses with Suspected Heart Failure
- Extra-Cardiac Anomalies Potentially Leading to Heart Failure in the Fetus
- Fetal Anemia
- Cardiovascular Changes in Fetal Anemia
- Treatment of Fetal Anemia
- Vein of Galen Malformations
- Cardiovascular Changes in Vein of Galen Aneurysmal Malformation
- Treatment of Fetal Vein of Galen Aneurysmal Malformation
- Placental Chorioangioma
- Cardiovascular Changes
- Prenatal Management
- Teratoma
- Cardiovascular Changes
- Treatment of Fetal Teratomas
- Twin-To-Twin Transfusion Syndrome
- Pathophysiology and Cardiovascular Changes
- Diagnosis, Staging and Treatment of Twin-To-Twin Transfusion Syndrome
- Twin-Reversed Arterial Perfusion (Trap) Sequence
- Cardiovascular Changes in Twin-Reversed Arterial Perfusion Sequence
- Treatment of Twin-Reversed Arterial Perfusion Sequence
- Congenital Pulmonary Airway Malformations
- Cardiovascular Changes in Congenital Pulmonary Airway Malformations
- Treatment for Congenital Pulmonary Airway Malformations
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 6 Heart Failure in Fetuses
- James C. Huhta and Nathalie J. M. Bravo-Valenzuela
- The Fetal Circulation and Heart Failure
- Causes of Fetal Heart Failure
- Prognosis of Fetal Heart Failure-Markers of Fetal Mortality and the Cardiovascular Profile
- Score
- How to Access the Fetal Cardiac Function by Fetal
- Echocardiography/ Cardiac Ultrasound?
- Cardiac Biometry
- Cardiac Output
- Ejection Fraction and Shortening Fraction
- Mitral, Tricuspid and Interventricular Septum Annular Plane Systolic Excursions
- Myocardial Performance Index or Tei Index
- E-A and E’/A’ Relationship
- Venous Doppler: Umbilical Vein, Ductus Venosus, and Pulmonary Vein
- Advanced Techniques for Evaluation of Myocardial Function
- Spatio-Temporal Image Correlation (Stic)
- 2D Speckle Tracking and Image of Strain/Strain Rate
- A Score for the Evaluation of Fetal Heart Failure: Cardiovascular Score
- Medical Treatment of Fetal Heart Failure
- Conclusions
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 7 Extra Cardiac Defects in Fetuses with Congenital Heart Diseases
- Alberto Borges Peixoto and Edward Araujo Júnior
- Introduction
- First-Trimester Screening for Fetal Abnormalities
- Congenital Heart Disease and Association with Extra-Fetal Fetal
- Abnormalities
- Atrioventricular Septal Defect (Avsd)
- Ventricular Septal Defect (Vsd)
- Conotruncal Anomalies
- Tetralogy of Fallot
- Double Outlet Right Ventricle (Dorv)
- Common Arterial Trunk
- Transposition of the Great Arteries
- Hypoplastic Left Heart Syndrome
- Tricuspid Atresia
- Abnormalities of the Aortic Arch
- Aorta Coarctation
- Interrupted Aortic Arch
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 8 Genetics and Congenital Heart Disease
- Patricia Santana Correia
- Introduction
- Classification of Congenital Anomalies
- Type of Problem in Morphogenesis
- Etiology of Birth Defects
- Congenital Heart Defects
- Some Syndromes with Cardiopathy Identified in the Perinatal Period
- Cytogenetically Visible Chromosomal Abnormalities
- Microdeletion Syndromes
- Monogenic Diseases
- Teratogenic Syndromes
- Laboratory Investigation
- Cytogenetic Analysis (Karyotype)
- Comparative Genomic Hybridization (Cgh Array)
- In Situ Hybridization with Fluorescence (Fish)
- DNA Sequencing and Detection of Specific Mutations
- Evaluation of Infants with Congenital Heart Disease
- Genetic Counseling
- Some Useful Sites
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 9 Environmental Factors Associated with Congenital Heart Diseases
- Ana Luisa Neves
- Introduction
- Environmental Factors Associated with Congenital Heart
- Diseases
- Demographic and Conditions
- Demographics
- Diabetes
- Phenylketonuria
- Maternal Lupus or Sjögrens
- Maternal Febrile Illness and Infections
- Hyperhomocysteinemia
- Hypertension
- Overweight and Obesity
- Assisted Reproduction Technology
- Socioeconomic Status
- Stress
- Environmental Factors Associated with Congenital Heart
- Diseases – Therapeutic Drug Exposures
- Antihypertensive Drugs
- Bronchodilators
- Anticonvulsant Drugs
- Lithium
- Antidepressant Drugs
- Vitamin K Antagonists
- Anti-Infection Drugs
- Retinoic Acid
- Thalidomide
- Nonsteroidal Anti-Inflammatory Drugs
- Protective Effect of Folic Acid
- Vitamin D
- Environmental Factors Associated with Congenital Heart Diseases – Nontherapeutic Drug Exposures
- Alcohol
- Caffeine
- Cigarette Smoking
- Other Drugs
- Air Pollution
- Chemical Exposures/Organic Solvents
- Water Contamination
- Hazardous Waste Sites
- Other Environmental Exposures
- Conclusion
- Consent for Publication
- Conflict of Interest
- Acknowledgements
- References
Chapter 10 Labor Management of Pregnant Women with Fetuses With Congenital Heart Diseases
- Edward Araujo Júnior, Christiane Simioni, Milene Carvalho Carrilho and Luciano
- Marcondes Machado Nardozza
- Introduction
- Prenatal Diagnosis of Heart Defects
- Congenital Heart Defects Without the Risk of Hemodynamic Instability at Birth
- Congenital Heart Defects with a Minimal Risk of Hemodynamic Instability at Birth
- Congenital Heart Defects with a High Risk of Hemodynamic Instability at Birth
- Type of Birth in Congenital Heart Diseases Diagnosed in the Prenatal Period
- Interatrial Septal Anomalies
- Ventricular Septal Defects
- Atrioventricular Septal Defects
- Hypoplastic Left Heart Syndrome
- Right Ventricle Hypoplasia (Pulmonary Atresia with Intact Ventricular Septum/Tricuspid Atresia)
- Univentricular Heart
- Aortic Stenosis and Pulmonary Stenosis
- Coarctation of the Aorta
- Ebstein's Anomaly
- Tetralogy of Fallot
- Transposition of the Great Arteries
- Double Outlet Right Ventricle
- Planning the Birth of Fetuses Diagnosed with Congenital Heart Diseases
- Selecting the Hospital and the Transfer of the Newborn
- Gestational Age at Delivery
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Author
- Alberto Borges Peixoto
- Edward Araujo Júnior
- Nathalie Jeanne M. Bravo-Valenzuela