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Diagnostics
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Advances in Fetal Cardiology
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Advances in Fetal Cardiology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 3665

Special Issue Editor

Prof. Dr. Maciej Słodki

E-Mail Website
Guest Editor
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
Interests: fetal cardiology and echocardiography; congenital heart diseases; fetal cardiac problems

Special Issue Information

Dear Colleagues,

The role of fetal cardiology is constantly expanding due to advances in imaging technology and the growing accessibility of fetal echocardiography, potentially enabling prenatal cardiology. Fetal echocardiography is key to planning perinatal and delivery room care for neonates with congenital heart disease, allowing healthcare providers to prepare for and appropriately manage critically born neonates.

Fetal echocardiography is also used to monitor pregnancies in patients with diabetes mellitus, preeclampsia, during maternal pharmacotherapy and other maternal diseases which may affect fetal development. It also plays a key role in monitoring the outcomes of fetal therapy, including pharmaco-transplacental therapy in arrythmias and invasive procedures such as laser therapy or fetal surgery when treating twin-to-twin transfusion syndrome, diaphragmatic hernia, meningomyelocele, extracardiac tumors, etc.

The number of publications concerning fetal cardiology and fetal echocadiography is on the rise; PubMed Central currently lists 800 papers concerning fetal cardiology. Researchers are encouraged to add to this growing body of work by submitting to this Special Issue. Potential topics include (but are not limited to) maternal–fetal medicine (MFM), perinatology, genetics, neonatology, pediatric cardiology, cardiac surgery, and palliative medicine.

Prof. Dr. Maciej Słodki
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • fetal cardiology
  • echocardiography
  • medical imaging
  • diagnosis

Published Papers (4 papers)

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Research

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17 pages, 2837 KiB  
Article
Associated Anomalies and Outcome in Patients with Prenatal Diagnosis of Aortic Arch Anomalies as Aberrant Right Subclavian Artery, Right Aortic Arch and Double Aortic Arch
by Roland Axt-Fliedner, Asia Nazar, Ivonne Bedei, Johanna Schenk, Maleen Reitz, Stefan Rupp, Christian Jux and Aline Wolter
Diagnostics 2024, 14(3), 238; https://doi.org/10.3390/diagnostics14030238 - 23 Jan 2024
Viewed by 777
Abstract
We aimed to evaluate retrospectively associated anomalies and outcome in prenatal aortic arch anomalies (AAAs). We included ninety patients with aberrant right subclavian artery (ARSA), right aortic arch (RAA) with mirror image branching (RAA-mirror) or aberrant left subclavian artery (RAA-ALSA) and double aortic [...] Read more.
We aimed to evaluate retrospectively associated anomalies and outcome in prenatal aortic arch anomalies (AAAs). We included ninety patients with aberrant right subclavian artery (ARSA), right aortic arch (RAA) with mirror image branching (RAA-mirror) or aberrant left subclavian artery (RAA-ALSA) and double aortic arch (DAA) between 2011 and 2020. In total, 19/90 (21.1%) had chromosomal anomalies, the highest rate being within the ARSA subgroup (17/46, 37%). All (13/13) of the RAA-mirror subgroup, 10/27 (37.0%) of RAA-ALSA, 13/46 (28.3%) of ARSA and 0/4 within the DAA subgroup had additional intracardiac anomaly. The rate of extracardiac anomalies was 30.7% in RAA-mirror, 28.3% in ARSA, 25.0% in DAA and 22.2% in the RAA-ALSA subgroup. A total of 42/90 (46.7%) had isolated AAAs: three (7.1%) with chromosomal anomalies, all trisomy 21 (3/26, 11.5%) within the ARSA subgroup. Out of 90, 19 (21.1%) were lost to follow-up (FU). Two (2.2%) intrauterine deaths occurred, and six (6.7%) with chromosomal anomalies terminated their pregnancy. In total, 63 (70.0%) were liveborn, 3/63 (4.8%) with severe comorbidity had compassionate care and 3/60 (5.0%) were lost to FU. The survival rate in the intention-to-treat cohort was 53/57 (93%). Forty-one (77.4%) presented with vascular ring/sling, two (4.9%) with RAA-ALSA developed symptoms and one (2.4%) needed an operation. We conclude that intervention due to vascular ring is rarely necessary. NIPT could be useful in isolated ARSA cases without higher a priori risk for trisomy 21 and after exclusion of other anomalies. Full article
(This article belongs to the Special Issue Advances in Fetal Cardiology)
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15 pages, 4514 KiB  
Article
Cardiac Adaptation and Preferential Streaming in Fetuses with Multiple Nuchal Cords
by Julia Murlewska, Sławomir Witkowski, Łucja Biały, Maria Respondek-Liberska, Maciej Słodki and Iwona Strzelecka
Diagnostics 2024, 14(1), 77; https://doi.org/10.3390/diagnostics14010077 - 28 Dec 2023
Viewed by 605
Abstract
The echocardiographic monitoring of a fetus with multiple nuchal cords around the fetal neck is important as it may result in cardiac remodeling and preferential streaming, thus affecting the condition of the fetus. The main aim of our study was to assess whether [...] Read more.
The echocardiographic monitoring of a fetus with multiple nuchal cords around the fetal neck is important as it may result in cardiac remodeling and preferential streaming, thus affecting the condition of the fetus. The main aim of our study was to assess whether the collision of the umbilical cord around the fetal neck can lead to discrepancies in the size of the pulmonary artery and the aorta in the three-vessel view and to an increase in the size of the heart, which may result from the compression of the carotid arteries caused by the umbilical cord wrapping around the fetal neck. A total number of 854 patients were included in this study and divided into three groups. Group A (control group) included 716 fetuses (84%) without the umbilical cord around the fetal neck. Group B (study group B) included 102 fetuses (12%) with one coil of the umbilical cord around the fetal neck. Group C (study group C) included 32 fetuses (4%) with two coils of the umbilical cord around the fetal neck. The range of the gestational age of the patients considered for this study was 27–40.2 weeks based on the ultrasound biometry and was not statistically different between the analyzed groups A, B and C (p > 0.05). The Pa/Ao index was calculated by dividing the value of the width of the pulmonary artery (in mm) to the width of the aorta (in mm) measured in the ultrasound three-vessel view. We found that fetuses that the fetuses with one and two coils of the umbilical cord around the neck showed significantly higher values of the width of the pulmonary trunk with the unchanged value of the aorta width. Therefore, we also observed significantly higher values of the ratio of the pulmonary trunk to the aorta for the fetuses wrapped with the umbilical cord around the neck compared with the control group without the umbilical cord around the neck (. Moreover, in the fetuses with one and two coils of the umbilical cord around the fetal neck, an increased amount of amniotic fluid was observed, whereas larger dimensions of CTAR in the fetuses with two coils of the umbilical cord around the neck were present (p < 0.05). The wrapping of the fetus with the umbilical cord around the fetal neck may induce the redistribution of blood flow, leading to fetal heart enlargement and disproportion and may be the cause of polyhydramnios. Full article
(This article belongs to the Special Issue Advances in Fetal Cardiology)
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13 pages, 277 KiB  
Article
The Influence of Maternal Condition on Fetal Cardiac Function during the Second Trimester
by Shifa Yao, Tian Yang, Xiaoxiao Kong, Yuanyuan Dang, Ping Chen and Mingli Lyu
Diagnostics 2023, 13(17), 2755; https://doi.org/10.3390/diagnostics13172755 - 25 Aug 2023
Viewed by 737
Abstract
Objective: Maternal health has a direct, profound and lasting effect on the formation and development of the fetal cardiovascular system. The aim of this research was to find whether maternal age, BMI hypertension (GH) or gestational diabetic mellitus (GDM) would affect fetal cardiac [...] Read more.
Objective: Maternal health has a direct, profound and lasting effect on the formation and development of the fetal cardiovascular system. The aim of this research was to find whether maternal age, BMI hypertension (GH) or gestational diabetic mellitus (GDM) would affect fetal cardiac function in the second trimester. Method: 329 mothers who had a fetal echocardiogram examination at the International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai, China, from 1 January 2020 to 30 April 2020 were enrolled at the gestational age of 21 to 26 weeks (mean 22.78 ± 1.13 weeks). Single-factor analysis and multi-factor line regression analysis were used to find the contribution values of each factor to fetal cardiac function. Results: at the second trimester, maternal age had a minor influence on the fetal left ventricle diastolic function. Higher maternal BMI could cause a decrease in the fetal diastolic function of both the left and right ventricle and the systolic function of the left ventricle. Maternal hypertension and gestational diabetic mellitus had a profound influence on both the left and right fetal heart ventricles of both systolic and diastolic function. Conclusion: maternal condition will have a profound influence on fetal cardiac function as early as the second trimester. Full article
(This article belongs to the Special Issue Advances in Fetal Cardiology)

Review

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28 pages, 19462 KiB  
Review
Evolution of Fetal Cardiac Imaging over the Last 20 Years
by Nathalie Jeanne Magioli Bravo-Valenzuela, André Souza Malho, Caroline de Oliveira Nieblas, Pedro Teixeira Castro, Heron Werner and Edward Araujo Júnior
Diagnostics 2023, 13(23), 3509; https://doi.org/10.3390/diagnostics13233509 - 22 Nov 2023
Viewed by 1118
Abstract
The purpose of this article is to describe the evaluation of a variety of congenital heart diseases (CHDs) using three-dimensional (3D) ultrasound with different software, such as Cristal Vue, Realistic Vue, LumiFlow, and Spatiotemporal Image Correlation (STIC), with HDlive and HDlive Flow Silhouette [...] Read more.
The purpose of this article is to describe the evaluation of a variety of congenital heart diseases (CHDs) using three-dimensional (3D) ultrasound with different software, such as Cristal Vue, Realistic Vue, LumiFlow, and Spatiotemporal Image Correlation (STIC), with HDlive and HDlive Flow Silhouette modes. These technologies provide realistic images of the fetal heart and cardiac vessels using a fixed virtual light source that allows the operator to freely select a better light source position to enhance the cardiovascular anatomical details. In addition, Fetal Intelligent Navigation Echocardiography (FINE) technology, also known as “5D Heart” or “5D”, is a technology that enables the automatic reconstruction of the nine standard fetal echocardiographic views and can alert non-specialists to suspected CHD. Through the use of artificial intelligence, an ultrasound machine is able to perform automatic anatomical and functional measurements. In addition, hese technologies enable the reconstruction of fetal cardiac structures in realistic images, improving the depth perception and resolution of anatomic cardiac details and blood vessels compared to those of standard two-dimensional (2D) ultrasound. Full article
(This article belongs to the Special Issue Advances in Fetal Cardiology)
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