TY - JOUR
T1 - The prognosis of common arterial trunk from a fetal perspective
T2 - A prenatal cohort study and systematic literature review
AU - van Nisselrooij, Amber E L
AU - Herling, Lotta
AU - Clur, Sally-Ann
AU - Linskens, Ingeborg H
AU - Pajkrt, Eva
AU - Rammeloo, Lukas A
AU - Ten Harkel, Arend D J
AU - Hazekamp, Mark G
AU - Blom, Nico A
AU - Haak, Monique C
N1 - Funding Information: We would like to thank Jan Schoones, a medical librarian at the Leiden University Medical Centre, for the assistance in the literature search. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2021 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.
PY - 2021/5
Y1 - 2021/5
N2 - OBJECTIVE: The limited number of large fetal cohort studies on common arterial trunk (CAT) impedes prenatal counseling at midgestation. This study evaluates the prognosis of CAT from a fetal perspective.METHOD: Fetuses with a prenatally diagnosed CAT were extracted from the PRECOR registry (2002-2016). We evaluated fetal and postnatal survival and the presence of additional morbidity at last follow-up. Literature databases were searches systematically for additional cases.RESULTS: Thirty-eight cases with a prenatal diagnosis of CAT were identified in our registry, of which 18/38 (47%) opted for pregnancy termination (TOP). Two cases resulted in spontaneous intrauterine demise (10%, 2/20), six cases demised postnatally (33%, 6/18), leaving 60% (12/20) alive, after exclusion of TOP, at a mean age of six (range: 2-10 years). Additional morbidity was found in 42% (5/12) of survivors, including 22q11.2 deletion syndrome, Adams-Oliver syndrome and intestinal atresia, whereas 8% (1/12) had developmental delay. The remaining 30% (6/12) of survivors appeared isolated with normal development. All of whom six required replacement of the initial right ventricle to pulmonary artery conduit. Additionally, we reviewed 197 literature cases on short-term outcome.CONCLUSION: The risk of fetal and neonatal demise, as well as significant morbidity amongst survivors, should be included in prenatal counseling for CAT.
AB - OBJECTIVE: The limited number of large fetal cohort studies on common arterial trunk (CAT) impedes prenatal counseling at midgestation. This study evaluates the prognosis of CAT from a fetal perspective.METHOD: Fetuses with a prenatally diagnosed CAT were extracted from the PRECOR registry (2002-2016). We evaluated fetal and postnatal survival and the presence of additional morbidity at last follow-up. Literature databases were searches systematically for additional cases.RESULTS: Thirty-eight cases with a prenatal diagnosis of CAT were identified in our registry, of which 18/38 (47%) opted for pregnancy termination (TOP). Two cases resulted in spontaneous intrauterine demise (10%, 2/20), six cases demised postnatally (33%, 6/18), leaving 60% (12/20) alive, after exclusion of TOP, at a mean age of six (range: 2-10 years). Additional morbidity was found in 42% (5/12) of survivors, including 22q11.2 deletion syndrome, Adams-Oliver syndrome and intestinal atresia, whereas 8% (1/12) had developmental delay. The remaining 30% (6/12) of survivors appeared isolated with normal development. All of whom six required replacement of the initial right ventricle to pulmonary artery conduit. Additionally, we reviewed 197 literature cases on short-term outcome.CONCLUSION: The risk of fetal and neonatal demise, as well as significant morbidity amongst survivors, should be included in prenatal counseling for CAT.
UR - http://www.scopus.com/inward/record.url?scp=85101764300&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/pd.5907
DO - https://doi.org/10.1002/pd.5907
M3 - Article
C2 - 33480066
SN - 0197-3851
VL - 41
SP - 754
EP - 765
JO - Prenatal diagnosis
JF - Prenatal diagnosis
IS - 6
ER -