Heart defects Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(9):227-233
DOI 10.1590/S0100-72032011000900002
PURPOSE: To evaluate the coping strategies of women facing a diagnosis of fetal heart disease. METHODS: We interviewed 50 women who had received a diagnosis of fetal heart disease. For data collection we used a semi-directed and Coping Strategy Inventory. The interview was conducted, on average, 22 days after the diagnosis. RESULTS: When asked how they felt about the baby, 56.0% reported concern and fragility, while the remaining 44.0% said they were happy and well. The strategies most used by women were problem solving (73.0%), social support (69.1%) and escape/avoidance (62.7%), and the least used strategy was removal (17.3%). It was found that women with partners, as well as those with 1 or 2 children, used more the problem-solving strategy (p<0.05). CONCLUSIONS: The active coping strategies, focused on problem solving and seeking social support, coupled with the responsibility and the need for specific care for the survival and welfare of the baby, brought about a closer relationship with the pregnancy, strengthening the maternal-fetal bond.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(9):227-233
DOI 10.1590/S0100-72032011000900002
PURPOSE: To evaluate the coping strategies of women facing a diagnosis of fetal heart disease. METHODS: We interviewed 50 women who had received a diagnosis of fetal heart disease. For data collection we used a semi-directed and Coping Strategy Inventory. The interview was conducted, on average, 22 days after the diagnosis. RESULTS: When asked how they felt about the baby, 56.0% reported concern and fragility, while the remaining 44.0% said they were happy and well. The strategies most used by women were problem solving (73.0%), social support (69.1%) and escape/avoidance (62.7%), and the least used strategy was removal (17.3%). It was found that women with partners, as well as those with 1 or 2 children, used more the problem-solving strategy (p<0.05). CONCLUSIONS: The active coping strategies, focused on problem solving and seeking social support, coupled with the responsibility and the need for specific care for the survival and welfare of the baby, brought about a closer relationship with the pregnancy, strengthening the maternal-fetal bond.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):304-309
DOI 10.1590/S0100-72032006000500007
PURPOSE: to analyze the results of a screening and diagnostic program of arrhythmias and congenital heart disease in a reference hospital and the relevance of early diagnosis in the fetal and neonate evolution. METHODS: cardiac evaluation of 1159 fetuses was done in two different levels. Level I: by morphological ultrasound examination with the objective to detect the existence of either arrhythmias or structural cardiac malformations. Level II: by fetal echocardiography to establish the differential diagnosis. The results of level I in the arrhythmia group were compared with those of level II, and in the group with malformations the results of both levels were confronted with the neonate echocardiogram or necropsy. The kappa index was calculated to evaluate the concordance between the two levels. RESULTS: all detected arrhythmias in level I were confirmed in level II, there were no false negative cases and five patients with severe arrhythmia required pharmacological therapy. The diagnosis of structural malformation by level I had sensitivity of 72% and specificity of 98% and there were 28% of false-positive cases. In level II, the sensitivity and specificity of the diagnosis of congenital heart disease were 100 and 99%, respectively. The kappa index was 57% and indicated a moderate degree of concordance between the two levels. Fifty-one percent of the fetuses with diagnosis of cardiac malformations required pharmacological or invasive intervention immediately after birth. CONCLUSION: morphological ultrasound examination is a important tool in the screening of arrhythmias and congenital heart defects during fetal life. The sensitivity and specificity of the fetal echocardiogram were very high and the early diagnosis made it possible to treat the fetus with severe cardiac disease either during pregnancy or immediately after birth.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):304-309
DOI 10.1590/S0100-72032006000500007
PURPOSE: to analyze the results of a screening and diagnostic program of arrhythmias and congenital heart disease in a reference hospital and the relevance of early diagnosis in the fetal and neonate evolution. METHODS: cardiac evaluation of 1159 fetuses was done in two different levels. Level I: by morphological ultrasound examination with the objective to detect the existence of either arrhythmias or structural cardiac malformations. Level II: by fetal echocardiography to establish the differential diagnosis. The results of level I in the arrhythmia group were compared with those of level II, and in the group with malformations the results of both levels were confronted with the neonate echocardiogram or necropsy. The kappa index was calculated to evaluate the concordance between the two levels. RESULTS: all detected arrhythmias in level I were confirmed in level II, there were no false negative cases and five patients with severe arrhythmia required pharmacological therapy. The diagnosis of structural malformation by level I had sensitivity of 72% and specificity of 98% and there were 28% of false-positive cases. In level II, the sensitivity and specificity of the diagnosis of congenital heart disease were 100 and 99%, respectively. The kappa index was 57% and indicated a moderate degree of concordance between the two levels. Fifty-one percent of the fetuses with diagnosis of cardiac malformations required pharmacological or invasive intervention immediately after birth. CONCLUSION: morphological ultrasound examination is a important tool in the screening of arrhythmias and congenital heart defects during fetal life. The sensitivity and specificity of the fetal echocardiogram were very high and the early diagnosis made it possible to treat the fetus with severe cardiac disease either during pregnancy or immediately after birth.
