Key result
Fetal cardiac interventions demonstrated a negligible impact on maternal safety and pregnancy course, with only 1 major complication (placental abruption) across 128 procedures.
Why the study?
While fetal cardiac interventions aim to benefit the fetus, the safety of the mother is of utmost importance, prompting evaluation of the impact of these procedures on maternal condition, course of pregnancy, and delivery.
Do percutaneous ultrasound-guided fetal cardiac interventions impact maternal safety, course of pregnancy, and delivery in mothers of fetuses with critical heart defects?
Observational (n=113)
Do percutaneous ultrasound-guided fetal cardiac interventions impact maternal safety, course of pregnancy, and delivery in mothers of fetuses with critical heart defects?
Percutaneous ultrasound-guided fetal cardiac interventions appear safe for mothers, with a very low rate of major complications and a high rate of term deliveries.
Supports maternal safety in fetal cardiac interventions; leaves open need for randomized trials before wider adoption.
The aim of fetal cardiac interventions (FCI), as other prenatal therapeutic procedures, is to bring benefit to the fetus. However, the safety of the mother is of utmost importance. The objective of our study was to evaluate the impact of FCI on maternal condition, course of pregnancy, and delivery. 113 mothers underwent intrauterine treatment of their fetuses with critical heart defects. 128 percutaneous ultrasound-guided FCI were performed and analyzed. The patients were divided into four groups according to the type of FCI: balloon aortic valvuloplasty (fBAV), balloon pulmonary valvuloplasty (fBPV), interatrial stent placement (IAS), and balloon atrioseptoplasty (BAS). Various factors: maternal parameters, perioperative data, and pregnancy complications, were analyzed. There was only one major complication-procedure-related placental abruption (without need for blood products transfusion). There were no cases of: procedure-related preterm prelabor rupture of membranes (pPROM), chorioamnionitis, wound infection, and anesthesia associated complications. Tocolysis was only necessary only in two cases, and it was effective in both. None of the patients required intensive care unit admission. The procedure was effective in treating polyhydramnios associated with fetal heart failure in six out of nine cases. Deliveries occurred at term in 89%, 54% were vaginal. The results showed that FCI had a negligible impact on a further course of pregnancy and delivery.
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Rebizant et al. (2021) conducted an observational in Fetuses with critical heart defects (n=113). Fetal cardiac interventions (FCI) was evaluated on Major maternal complications. Fetal cardiac interventions demonstrated a negligible impact on maternal safety and pregnancy course, with only 1 major complication (placental abruption) across 128 procedures.
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