AUTHOR=Deng Deng-pu , Qian Tao , Liu Yu-hong , Wu Zhong-shi , Lu Ting 

TITLE=Prenatal diagnosis, management, and outcomes of fetuses with tetralogy of Fallot in China after prenatal counseling: a prospective cohort study

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1172282

DOI=10.3389/fped.2023.1172282

ISSN=2296-2360

ABSTRACT=Objective:  The study aimed to monitor fetuses with tetralogy of Fallot (TOF) following prenatal counseling and its influence for parents’ decision to termination the pregnancy.
Methods: Fetuses with isolated TOF diagnosed between January 2019 and December 2021 were prospectively enrolled. Follow-up was up to termination or 6 months after operation.
Results: Of the 1026 fetuses diagnosed with cardiac defects, 129 were isolated TOF and completed the follow-up. Fifty-five (42.6%) fetuses were terminated, with larger maternal age (OR: 0.893, 95% CI: 0.806-0.989, P =0.031) as the protective factor. Maternal anxiety score, gestational weeks, and the pulmonary to aortic diameter ratio lost significance in multivariate analysis. Subjectively, worries about the prognosis (41.8%) and the possible suffering of the unborn child (18.2%) was the two most common reasons for termination of pregnancy. Prenatal diagnosis was accurate in 73 of the 74 (98.6%) live births. Of the 64 live births surgically repaired in our center, primary repair was performed for 57 (89.1%) with median age of 104 days, valve-sparing repair was achieved for 49 (76.6%). No perioperative death occurred.
Conclusions: Termination for fetuses with TOF remains common in China. Live births with TOF can be safely and effectively managed.