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Micro‐computed tomography of isolated fetal hearts following termination of pregnancy: A feasibility study at 8 to 12 weeks' gestation
Author(s) -
Sandaite Inga,
Lombardi Claudio,
Cook Andrew C,
Fabietti Isabella,
Deprest Jan,
Boito Simona
Publication year - 2020
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5719
Subject(s) - medicine , gestation , gestational age , fetus , pregnancy , computed tomography , fetal echocardiography , radiology , prenatal diagnosis , genetics , biology
Abstract Objectives To assess the feasibility of retrieval of intact human fetal hearts after first trimester surgical termination of pregnancy (TOP) and subsequent anatomical assessment by postmortem micro‐computed tomography (micro‐CT). Methods In a cohort of consenting women undergoing surgical TOP between 8 and 13 weeks' gestation, we attempted the retrieval of the fetal heart from the suction material. Specimens were immersion fixed in 10% formaldehyde, scanned by iodine‐enhanced micro‐CT and cardiac anatomy assessed by a multidisciplinary team using 3D‐multiplanar analysis. Results The median gestational age at TOP was 10.7 weeks (range 8.3‐12.9). In 57 (95.0%) out of 60 suction specimens, the heart could be retrieved. The median cardiac length was 5 mm (range 2‐8 mm), in three (5.3%), the heart was too damaged to assess cardiac anatomy and in five (8.7%) only the four chambers could be examined. In the remaining 49 (86.0%) cases, a detailed assessment of cardiac anatomy was possible, showing a major defect in two (4.1%) and a minor defect in four (8.2%). Conclusions Fetal hearts can be retrieved after first trimester TOP being intact in the vast majority of cases. Iodine‐enhanced, postmortem micro‐CT can be used to assess cardiac anatomy from as early as 8 weeks and to describe heart abnormalities.