Category: Ultrasound/Imaging
Poster Session I
Single ventricle defects (SVDs) are complex heart defects (CHD) often requiring multiple surgeries, and are associated with high morbidity and mortality rates. Therefore, termination of pregnancy (TOP) is an option for SVDs. We hypothesized that the timing of the diagnosis impacts parents' choices.
Study Design:
All patients with a congenital heart defect from 2012 to 2022 requiring single ventricular repair (hypoplastic left heart syndrome, double inlet left ventricle, pulmonic atresia with intact septum, unbalanced AV canal defect, and aortic coarctation with disproportionate ventricles) were included. The same perinatologist and pediatric cardiologist performed prenatal counseling. Maternal demographics, medical history, gestational age (GA) at diagnosis, ultrasound findings, genetic test results, and pregnancy outcome were collected. Wilcoxon rank-sum and Fisher's exact tests were used to compare continuous and categorical data, respectively. Odds ratios (ORs) were calculated using logistic regression.
Results:
A total of 158 patients were diagnosed with SVDs during the study period. Of those, 36 (23%) underwent TOP, and 122 (77%) either delivered or had a spontaneous abortion. Maternal age, race, marital status, and GA at diagnosis differed statistically (Table 1). GA at diagnosis and race were the only independent predictors of TOP decision (Table 2). The median GA at diagnosis was earlier in the TOP group (20.4 vs. 23.6 weeks) (p < 0.001). SVDs diagnosed in the first trimester were more likely to terminate compared to 2nd-trimester diagnoses (55% vs18%) (p=0.001). Earlier GA at diagnosis was correlated with earlier GA at termination (r= 0.92, p < 0.001) (Figure 1).
Conclusion:
The decision of TOP is more common when the SVD is diagnosed earlier in gestation. This could be due to less maternal bonding and lower maternal risks of the procedure. In addition, early diagnoses allow parents to make deliberate decisions.
Samantha Kegel, BS (she/her/hers)
University of Maryland School of Medicine
College Park, Maryland, United States
Hooman Tadbiri, MD, MPH
University of Maryland Medical Center
Baltimore, Maryland, United States
Erkan Cagliyan, MD
University of Maryland Medical Center
Baltimore, Maryland, United States
Jamie Mech, RDMS
University of Maryland
College Park, Maryland, United States
Lindsey Seger, BS, RDMS
Fetal Heart Program Sonographer Coordinator
University of Maryland Medical Center
Baltimore, Maryland, United States
Ozhan M. Turan, MD, PhD
University of Maryland Medical Center
Baltimore, Maryland, United States
Sifa Turan, MD, RDMS
University of Maryland School of Medicine
Baltimore, Maryland, United States