3 | RESULTS
A total of 108 CAT cases were identified by prenatal echocardiography,
of which 10 were detected before 20 weeks of pregnancy, 3 in the third
trimester, and the remaining 95 in the second trimester between 20 and
28 weeks. Forty-seven cases were the A1 type (43.5%, 47/108), 51 cases
were the A2 type (47.3%, 51/108), 9 cases were the A3 type (8.3%,
9/108), and 1 case was the A4 type (0.9%, 1/108). The A1 and A2
prenatal types were the most common, accounting for 90.7% (98/108) of
this cohort, but only 1 case of the A4 type was associated with an
aberrant right subclavian artery (Figures 4a, 4b). Among them, 22 cases
(20.4%) were isolated CAT, 56 cases (51.8%) were complicated with
complex intra-cardiac structural abnormalities, including total
endocardial cushion defects, single atrial-single ventricle, hypoplastic
left heart syndrome, persistent superior vena cava, atrial isomerism
syndrome, total anomalous pulmonary venous collection, left aortic arch
with aberrant right subclavian artery and left ductus arteriosus, right
aortic arch with aberrant left subclavian artery and left ductus
arteriosus, mirror image right aortic arch and left brachiocephalic
vein, etc (Table 1). 30 cases (27.8%) were complicated with
intra-cardiac and extra-cardiac structural abnormalities. A total of 55
systemic malformations were detected in 30 foetuses with abnormal
extra-cardiac structures, of which 17 were combined with 1 abnormality
in another system, 5 were combined with 2 other system abnormalities, 4
were combined with 3 other system abnormalities, and 4 cases were
combined with 4 other system abnormalities. The extra-cardiac system,
particularly the facial and physical abnormalities, had the highest
incidence (40.0%), followed by the urinary system (14.5%) and the
nervous system (14.5%) (Table 2). The STIC images were completely
displayed in 88 cases (81.5%), but satisfactory STIC volume images were
not obtained in the other 20 cases.
The pregnancy outcomes of all 108 foetuses were followed up. Among the
22 foetuses with isolated CAT, 1 case died in utero, 7 of the 16
foetuses died after birth, and 5 pregnant women and their families
terminated their pregnancies after antenatal consultation. Of the 86
cases of PTA complicated with other malformed foetuses, 7 cases chose to
continue the pregnancy and received timely surgical treatment after
delivery. Among them, 2 cases were in good health. The remainder were
combined with various complications. Eight intrauterine deaths, 10
postnatal deaths and 61 cases of pregnancy termination due to
complicated intra-cardiac and extra-cardiac malformations were
encountered. The incidence of combined other malformations was higher
than that of isolated PTA, resulting in an adverse pregnancy outcome
(20.37% vs 79.63%, P < 0.05; Table 3).