Ultraschall Med 2016; 37 - SL15_1
DOI: 10.1055/s-0036-1587780

The importance of isolated muscular ventricular septal defect (VSD) – diagnosed in the second trimester – for pregnancy and delivery

M Brenner 1, KH Eichhorn 1, E Schleußner 2
  • 1Gemeinschaftspraxis Frauenärzte, PD Dr. K.-H. Eichhorn, Dr. P. Martin, M. Brenner, Weimar, Germany
  • 2Frauenklinik der FSU Jena, Jena, Germany

Purpose: The aim was to evaluate the prevalence of isolated muscular ventricular septal defects, the association with chromosomal anomalies, the rate of spontaneous closure and the importance of the delivery procedure.

Material and methods: From January 2001 – December 2012 we carried out 23.500 fetal echocardiografies in the second trimester. Prevalence of VSDs were analyzed, furthermore the spontaneous closure rate, the rate of chromosomal anomalies. The frequency of caesarian section, natural delivery, forceps- and vacuum extraction delivery, preterm delivery and perinatal acidosis and other perinatal complications was compared to data from Thuringian-Perinatal-Statistic at the same time. Also we investigated the association between higher maternal age, obesity and isolated muscular VSD.

Results: 1060 congenital heart defects (CHD) were diagnosed, among 480 VSDs, in some cases with additionally intra- and extracardiac anomalies. After exclusion from these cases with additionally anomalies, we found 236 isolated VSDs, among them 185 were muscular and 51 perimembranous. One chromosomal anomaly was detected – a Klinefelder-syndrom, no case with a trisomy. In approximately 80% the isolated muscular VSD closured spontaneously prenatally or until the end of the first year of life. The pregnant women with a fetus with isolated muscular VSD were older as all pregnant women in our office, but the obesity-rate was similar. The percentage of spontaneous delivery was similar too compared with all births in Thuringia at the same time, the rate of caesarian section was higher. Also no different rates were found concerning preterm-birth and acidosis peripartual.

Conclusion: The most prenatal prevalent CHD is the VSD. The isolated muscular VSD had a similar risk of chromosomal anomalies like those of normal pregnancies. The prognosis is good concerning delivery, spontaneous closure and healthy life.