Table 1.

Cardiac Lesions and Situations Requiring Immediate Perinatal Attention

Cardiac LesionPotential ComplicationPotential Interventions
Simple transposition of the great arteries (associated with a restrictive atrial septum and arterial duct)Metabolic acidosisUrgent balloon atrial septostomy
Profound hypoxemia
Hypoplastic left heart syndrome or critical aortic stenosis (associated with an intact or restrictive atrial septum)Profound hypoxemiaUrgent balloon atrial septostomy or surgical septectomy
Metabolic acidosis
Obstructed total anomalous pulmonary venous drainageProfound hypoxemiaEarly surgical intervention
Absent pulmonary valve syndromeAirway compressionMechanical ventilation (positive pressure)
Plication of pulmonary arteries
Respiratory compromise or failure
Air trapping
Severe Ebstein anomaly of the tricuspid valvePulmonary hypoplasiaOxygen therapy
Respiratory failureMechanical ventilation (positive pressure)
Severe hypoxemiaInhaled nitric oxide
Management of hydropsDrainage of associated pleural effusions or ascites
Complete heart block with or without congenital heart diseaseCardiac failureMedical therapy with chronotropic agents
Temporary cardiac pacing
HydropsDrainage of associated pleural effusions or ascites
  • Availability of perinatal intervention increases impact of fetal cardiac screening programs. Reproduced from Hunter and Simpson2 with permission of the publisher. Copyright ©2014, Nature Publishing Group.