Birth of fetuses with heart defects: when caesarean?

Abstract

Introduction: Congenital heart defects are the most common type of congenital anomaly and represent all structural changes of the heart at birth, the result of a disorder in the cardiovascular embryonic development. Progress in ultrasound imaging techniques allowed the antenatal diagnosis of congenital heart defect. Antenatal detection is standard in reducing neonatal mortality. The aim of our study is to identify ways to assist at birth in pregnant women with fetuses with congenital heart defects, antenatal detected. Materials and methods: The paper represents a retrospective study conducted at the Obstetrics and Gynecology Clinic No.1 in the TgMures Emergency County Hospital, between 01st January-31th December 2013. Inclusion criteria included births assisted pregnancies with fetuses with heart defects. The reference was done to the total number of births, depending on many parameters: vaginal/caesarean, mature/premature, the main indication of caesarean section. Results: From the record we have identified 18 cases of pregnancies with fetal heart defects. Of all births of fetuses with hearts defects, 14 (77.8%) were mature, 4 (22.2%) premature, 17(94.5%) were completed by caesarean section and only one (5.5%) was natural birth. Of all births by caesarean 8(47%) cases had obstetric problems and only 9(53%) were due to congenital heart defects. Conclusions: In the group studied, delivery by Caesarean section was almost a rule. Antenatal detection rate is increasing because the means of diagnostic (ECHO) and multidisciplinary teams (obstetrician gynecologist, a cardiologist pediatrician, neonatology, genetics, cardiovascular surgeon). Most of the cases diagnosed antenatal allowed carrying the pregnancy to term.