Evaluation of fetal cardiac anomalies and their outcomes in isolated cardiac anomalies and non-isolated groups and based on minor and major abnormalities

Background: This study was aimed to evaluate the characteristics and outcomes of isolated CHD and non-isolated CHD and also compare with major and minor cardiac anomalies.
Methods: This prospective observational study was performed on 135 cases of CHD from September 2018 to December 2021. Patients were prospectively evaluated for abortion, intrauterine death, death during or after delivery, and live birth. Finally, these variables were compared between the two groups of minor and major CHD, and also isolated and non-isolated CHD.
Results: Out of 135 patients, 54 (40.0%) had minor and 81 (60.0%) had major CHD. Also, 78 cases (57.8%) were isolated and 57 cases (42.2%) were non-isolated. The most common minor anomalies are TR (21 cases, 15.6%) and VSD (19 cases, 14.1%), and the most common major anomalies are AVSDs (22 cases, 16.3%). 14 cases (43.8%) of minor CHD and 6 major CHD cases (10.2%), resulted in a live birth (p-Value = 0.002). Also, 18 cases (36.0%) of isolated CHD and only 2 cases (4.9%) of non-isolated CHD resulted in live birth (p-Value = 0.002). The most common extracardiac accompanying anomalies were head, neck, and central nervous system abnormalities, which were seen in 36 cases (26.7%). Moreover, 84.6% of isolated minor CHD cases without hydrops and cystic hygroma survived.
Conclusions: Generally, the major cardiac anomalies and their association with extracardiac abnormalities reduce the likelihood of live birth. Those minor anomalies accompanied by hydrops and cystic hygroma have a poorer prognosis than isolated minor anomalies.
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