Key result
Fetal echocardiography predicts critical LVOTO with ~96% positive predictive value to guide neonatal cardiac surgery.
Why the study?
The accuracy of fetal echocardiography in diagnosing critical left ventricular outflow tract obstruction and the impact of in utero transport to surgical centers on neonatal outcomes were not well established.
Does in utero transport to a neonatal cardiac surgical center improve outcomes in fetuses with suspected critical left ventricular outflow tract obstruction?
Population
22 consecutive fetuses with suspected critical left ventricular outflow tract obstruction at 21 to 38 weeks gestation
Comparison
In utero transport to neonatal cardiac surgical center for delivery and surgical treatment
Design
Observational case series
Follow-up
Until hospital discharge
Authors
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Hypothesis-generating for in utero transport in suspected critical LVOT obstruction; requires prospective validation before changing practice.
Observational (n=22)
No
Does in utero transport to a neonatal cardiac surgical center improve outcomes in fetuses with suspected critical left ventricular outflow tract obstruction?
In utero transport of fetuses with suspected critical left ventricular outflow tract obstruction to a specialized center allows for accurate diagnosis and yields a 77% surgical survival rate.
Chang et al. (1991) conducted an observational in Left ventricular outflow tract obstruction (n=22). In utero transport and neonatal cardiac surgery was evaluated on Positive predictive value of fetal echocardiography for critical left ventricular outflow tract obstruction. Fetal echocardiography predicted critical left ventricular outflow tract obstruction with a 96% positive predictive value, and 77% of neonates undergoing subsequent cardiac surgery survived.
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