PRENATAL DIAGNOSIS OF CONGENITAL HEART DEFECT IN TWINS

EXPERIENCE OF A FETAL MEDICINE REFERENCE SERVICE

Abstract

OBJECTIVE: Congenital heart defects represent the most frequent malformation at birth. In twin pregnancies, specific findings increase the risk of cardiac complications for the fetus. Due to the scarcity of data on Brazilian patients, the objective was to determine the incidence of cardiac alterations and their associations in this sample. METHODS: Observational, cross-sectional and retrospective study in a public hospital. Multiple pregnancies were evaluated through the application of a clinical protocol with data collection from the medical records of patients treated at a reference Fetal Medicine Service in southern Brazil from November 2008 to September 2019 RESULTS: 225 multiple pregnancies were included, of which 221 (98.2%) occurred spontaneously. Maternal mean age 27.5 (+or- 6.5) years. Median of 2 previous pregnancies. Most pregnancies were two fetuses (96.4%), dichorionic (64%) and diamniotic (93.3%). In 157 pregnancies (69.8%), the diagnosis of twins was made in the first trimester. Fetal echocardiography was performed in 56.9% of pregnancies. Heart defects were classified according to Botto et al. Cardiac alterations occurred in nine pregnancies (7%). Most pregnancies ended preterm (65%) CONCLUSIONS: It is necessary to recognize multiple pregnancy as a high-risk situation for fetal cardiac compromise and, from there, to increase the awareness of the general population and health professionals about the importance of prenatal diagnosis of congenital heart disease in these situations.