Key result
Fetal heart failure typically manifests as right heart failure and hydrops fetalis, and can be caused by structural heart disease, arrhythmias, or primary myocardial disease.
This review outlines the unique physiological mechanisms of the fetal circulation and the diverse etiologies that lead to fetal heart failure and hydrops fetalis.
Alerts clinicians to right heart predominance in fetal hydrops; leaves open prospective trials on etiology-specific interventions.
Clinical fetal heart failure occurs in conditions associated with increasing left and right atrial filling and/or central venous pressures and manifests as right heart failure with the development of pericardial and pleural effusions, ascites and peripheral and placental edema. Fetal heart failure may occur in primary myocardial disease, in presence of the extracardiac pathology impacting the loading conditions of the fetal heart and in conditions associated with secondary myocardial dysfunction including structural heart defects, bradycardia or tachycardia. This review summarizes recent literature of the understanding of the normal fetal circulation and the pathogenic mechanisms responsible for the evolution of fetal heart failure, strategies for fetal and perinatal management of fetal heart failure, and future directions that may lead to novel strategies to treat affected pregnancies and.
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Lisa K. Hornberger (2010) conducted a review in Fetal heart failure. Fetal heart failure typically manifests as right heart failure and hydrops fetalis, and can be caused by structural heart disease, arrhythmias, or primary myocardial disease.
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