Publication: Coartación de aorta: análisis de los criterios predictivos prenatales para su diagnóstico y pronóstico
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2017-02-09
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Universidad Complutense de Madrid
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Abstract
La coartación de aorta (CoAo) es una de las cardiopatías congénitas (CC) más frecuentes, representando aproximadamente un 5-10% de todos los recién nacidos vivos con CC. A pesar de los avances en la ecocardiografía fetal y la descripción de hallazgos prenatales asociados a la CoAo, sigue siendo una patología de muy difícil diagnóstico tanto en vida fetal como en el periodo neonatal precoz. La tasa de detección prenatal de la CoAo es baja, con varios estudios que publican cifras de detección por debajo del 40%. Además, la CoAo es también la patología cardiovascular crítica más frecuentemente no diagnosticada en el periodo neonatal precoz, siendo estos recién nacidos dados de alta sin haber sido diagnosticados, requiriendo posteriormente ingreso en estado de descompensación hemodinámica. En concreto, hasta un 60% de los casos son diagnosticados tras el alta del recién nacido. Actualmente existe evidencia de que el diagnóstico prenatal de esta patología mejora el pronóstico de estos niños, aumentando su supervivencia y reduciendo su morbilidad, puesto que permite una planificación adecuada del parto en un centro terciario y una prevención precoz del cierre ductal...
Coarctation of the aorta (CoAo) is one of the most common congenital heart defects (CHD), accounting for approximately 5-10% of all live births with CHD. Despite advances in fetal echocardiography and description of antenatal findings associated with CoAo, this defect remains as the most challenging cardiac diagnosis in fetal and early neonatal life. The prenatal detection rate of this condition in the obstetric population in general is disappointingly low with several papers reporting successful detection below 40%. Moreover, CoAo is also the most common life-threatening cardiovascular condition overlooked in the early neonatal period with these neonates often leaving the hospital undiagnosed only to return in a critical situation. This is particularly true in isolated CoAo, where 60% of the cases are diagnosed after discharge. There is now evidence to suggest that prenatal diagnosis of this condition improves survival and reduces morbidity by allowing planned delivery in an appropriate center and early prevention of ductal constriction...
Coarctation of the aorta (CoAo) is one of the most common congenital heart defects (CHD), accounting for approximately 5-10% of all live births with CHD. Despite advances in fetal echocardiography and description of antenatal findings associated with CoAo, this defect remains as the most challenging cardiac diagnosis in fetal and early neonatal life. The prenatal detection rate of this condition in the obstetric population in general is disappointingly low with several papers reporting successful detection below 40%. Moreover, CoAo is also the most common life-threatening cardiovascular condition overlooked in the early neonatal period with these neonates often leaving the hospital undiagnosed only to return in a critical situation. This is particularly true in isolated CoAo, where 60% of the cases are diagnosed after discharge. There is now evidence to suggest that prenatal diagnosis of this condition improves survival and reduces morbidity by allowing planned delivery in an appropriate center and early prevention of ductal constriction...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Obstetricia y Ginecología, leída el 07-06-2015