Fetal cardiac tumours in a referral prenatal cardiology centre – series of 37 cases with neonatal follow-up

Introduction
Fetal cardiac tumours are relatively rare findings. The aim of this research was to present the natural course in a series of 37 fetuses with cardiac tumours, who had fetal echocardiography performed and the pregnancies had been continued until term.

Material and methods
This was a retrospective analysis of 37 cases with prenatally detected heart tumour. The study group was divided into multiple- and single-tumour subgroups and into survivors versus non-survivors. The number of survivors in subgroups and the incidence of prognostic factors were compared by c2 test. The presence of additional cardiac anomalies, the way of delivery and neonatal follow-up was analysed. The literature (Pub Med) was reviewed.

Results
There was no statistical difference between the number of survivors in groups of single versus multiple tumours (p > 0.05). In group of non-survivors there was a higher incidence of bad prognostic factors detected prenatally: pericardial effusion, mitral regurgitation, and cardiomegaly (p < 0.05). The authors suggested a different way of perinatal care and counselling in multiple and single fetal heart tumours.

Conclusions
Fetal cardiac tumours in the majority of cases were rhabdomyoma, and in case of normal heart anatomy and normal intracardiac flow the short-term prognosis was good. Fetal single heart tumour with progression of its size in the third trimester may require early surgical resection, so delivery in a tertiary perinatal and cardiac surgery centre might be necessary. Pericardial effusion, mitral regurgitation, and cardiomegaly might implicate a worse prognosis in the case of fetal heart tumour. Fetal cardiac tumour may require a multispecialist team approach to benefit from early detection and diagnosis.