Score on Cardiovascular Profile Predicts Survival in Fetuses With Heart Failure


RENO, NEV. — A less-than-perfect score on a five-item, 10-point cardiovascular profile predicts a poorer outcome for a fetus with heart failure, according to a poster presented by Aleksandra Roczek, M.D., at the annual meeting of the Society for Maternal-Fetal Medicine.

Fetuses in this high-risk group warrant closer follow-up and management from both the obstetric and prenatal cardiology point of view, concluded Dr. Roczek of the University of South Florida, Tampa.

Poor scores on three of the five items—cardiomegaly, hydrops, and venous Doppler measurements—were especially predictive of mortality, Dr. Roczek noted.

She and her colleagues conducted a retrospective examination of 92 pregnancies where fetuses were judged to be at risk for heart failure on the basis of echocardiography and Doppler velocimetry. Of those fetuses, 53 (57%) survived and 39 (43%) did not.

The cardiovascular profile score awards two points each for absence of hydrops, normal venous Doppler, heart function, arterial Doppler, and heart size. The score in each domain is decreased by two points for severe signs and by one point for intermediate signs.

Fetuses with abnormal venous Doppler had a mortality rate of 64%. Mortality was 62.5% in fetuses with hydrops, and 60% in fetuses with cardiomegaly.

The other two factors were less predictive of mortality. Fetuses with abnormal heart function had a 33% mortality, and those with abnormal arterial Doppler had a 17% mortality.

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