FE Reporting & Counseling Flashcards

Fetal hydrops on echocardiography is defined by fluid accumulation in at least how many body compartments?

Answer: Two or more compartments

Fetal hydrops is defined by abnormal fluid accumulation in at least two body compartments (ascites, pleural effusion, pericardial effusion, skin edema).

Which cardiac lesion is most likely to require fetal intervention (in-utero balloon valvuloplasty)?

Answer: Critical aortic stenosis with evolving HLHS

Critical aortic stenosis with evidence of evolving hypoplastic left heart syndrome may be treated with fetal aortic balloon valvuloplasty to promote biventricular heart development.

When a fetal cardiac abnormality is detected, chromosomal microarray analysis is recommended because:

Answer: It detects submicroscopic copy number variants that karyotype misses

Chromosomal microarray detects submicroscopic copy number variants (CNVs), including 22q11.2 deletion, that standard karyotype will miss but are clinically relevant.

Which cardiac defect is most strongly associated with 22q11.2 deletion (DiGeorge syndrome)?

Answer: Truncus arteriosus and interrupted aortic arch type B

22q11.2 deletion (DiGeorge/velocardiofacial syndrome) is strongly associated with conotruncal defects, especially truncus arteriosus and interrupted aortic arch type B.

Which medication used for fetal arrhythmia therapy requires maternal EKG monitoring for maternal cardiac toxicity?

Answer: Both sotalol and flecainide

Both sotalol (QTc prolongation risk) and flecainide (proarrhythmic risk) require maternal ECG monitoring when used transplacentally for fetal arrhythmia.

The Ebstein anomaly severity in the fetus is best predicted by which index?

Answer: Celermajer index (right heart to left heart ratio)

The Celermajer index (ratio of right atrium + atrialized right ventricle area to functional right ventricle + left ventricle + left atrium area) predicts prognosis in fetal Ebstein anomaly.