Diagnosis and Treatment of Fetal Cardiac Disease

作者：Mary T. Donofrio, Anita J. Moon‐Grady, Lisa K. Hornberger, Joshua A. Copel, Mark Sklansky, Alfred Abuhamad, Bettina F. Cuneo, James C. Huhta, Richard A. Jonas, Anita N. Krishnan, Stephanie Lacey, Wesley Lee, Erik C. Michelfelder, Gwen R. Rempel, Norman Henry Silverman, Thomas L. Spray, Janette F. Strasburger, Wayne Tworetzky, Jack R. Rychik · 发表于：Circulation · 年份：2014 · DOI：10.1161/01.cir.0000437597.44550.5d · 被引用次数：1280 · 研究领域：Congenital Heart Disease Studies、Neonatal and fetal brain pathology、Assisted Reproductive Technology and Twin Pregnancy

BACKGROUND: The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. METHODS AND RESULTS: A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Availa...