2025 Volume 61 Issue 1 Pages 77-84
Background: Prenatal diagnosis of isolated PCFO/PRFO（premature closure or restriction of the foramen ovale in fetuses with structurally normal heart）is increasing, but there are no reports on severity assessment of the association between fetal echocardiographic findings and postnatal symptoms.
Aims: To investigate the clinical features and severity prediction of patients prenatally diagnosed with isolated PCFO/PRFO.
Methods: Twenty-two patients who were prenatally diagnosed with isolated PCFO/PRFO between 2007 and 2014 were included in the study and divided into two groups: a treatment group in which respiratory symptoms were observed after birth and required therapeutic intervention, and a no-treatment group in which no symptoms were observed or respiratory symptoms resolved spontaneously. The timing of prenatal diagnosis, postnatal clinical course, patient background, and fetal echocardiography findings were compared retrospectively from medical records.
Results: Prenatal diagnosis was made at a median gestational age of 35 weeks in both groups. Among these patients, 10 were treatment group（45％）and 12 were no-treatment group（55％）. Respiratory symptoms worsened in 12/22 patients（55％）by 24 hours after birth. Fetal echocardiographic findings were: ASA（atrial septal aneurysm）was more common in the treatment group. RVDd Z-score was not significantly different, but LVDd Z-score was significantly lower in the treatment group. TVD/MVD and PVD/AVD were higher in the treatment group. LVDd Z-score ＜−2.5, TVD/MVD ＞ 1.50, and PVD/AVD ＞ 1.40 were highly sensitive and specific indicators as cutoff values to predict the treatment group.
Conclusion: Continuous fetal assessment is necessary, with a focus on the rapid increase in the TVD/MVD in late pregnancy.
