Key result
Multiple fetal cardiac tumors show no difference in neonatal survival compared to single tumors.
Why the study?
Fetal cardiac tumours are rare and their natural course and prognostic factors require further characterization to guide perinatal care and counseling.
What are the prognostic factors and natural course of prenatally detected fetal cardiac tumours?
Observational (n=37)
No
What are the prognostic factors and natural course of prenatally detected fetal cardiac tumours?
Absolute Event Rate: 79% vs 54%
p-value: p=0.1434
Fetal cardiac tumours generally have a good short-term prognosis, but the presence of pericardial effusion, mitral regurgitation, and cardiomegaly are associated with worse outcomes.
Retrospective series of 37 fetal cardiac tumours describes natural history; leaves open need for prospective studies to guide prenatal management.
Introduction: Fetal cardiac tumours are relatively rare findings.The aim of this research was to present the natural course in a series of 37 fetuses with cardiac tumours, who had fetal echocardiography performed and the pregnancies had been continued until term.Material and methods: This was a retrospective analysis of 37 cases with prenatally detected heart tumour.The study group was divided into multiple-and single-tumour subgroups and into survivors versus non-survivors.The number of survivors in subgroups and the incidence of prognostic factors were compared by c 2 test.The presence of additional cardiac anomalies, the way of delivery and neonatal follow-up was analysed.The literature (Pub Med) was reviewed.Results: There was no statistical difference between the number of survivors in groups of single versus multiple tumours (p > 0.05).In group of non-survivors there was a higher incidence of bad prognostic factors detected prenatally: pericardial effusion, mitral regurgitation, and cardiomegaly (p < 0.05).The authors suggested a different way of perinatal care and counselling in multiple and single fetal heart tumours.Conclusions: Fetal cardiac tumours in the majority of cases were rhabdomyoma, and in case of normal heart anatomy and normal intracardiac flow the short-term prognosis was good.Fetal single heart tumour with progression of its size in the third trimester may require early surgical resection, so delivery in a tertiary perinatal and cardiac surgery centre might be necessary.Pericardial effusion, mitral regurgitation, and cardiomegaly might implicate a worse prognosis in the case of fetal heart tumour.Fetal cardiac tumour may require a multispecialist team approach to benefit from early detection and diagnosis.
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Strzelecka et al. (2019) conducted an observational in Fetal cardiac tumours (n=37). Multiple fetal cardiac tumours vs. Single fetal cardiac tumours was evaluated on Neonatal survival (p=0.1434). Neonatal survival did not differ significantly between fetuses with multiple (79%) and single (54%) cardiac tumours, whereas non-survivors had a significantly higher incidence of pericardial effusion, cardiomegaly, and mitral regurgitation.
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