Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2023; 15(10): 500-507
Published online Oct 26, 2023. doi: 10.4330/wjc.v15.i10.500
Integrated analysis of comorbidity, pregnant outcomes, and amniotic fluid cytogenetics of fetuses with persistent left superior vena cava
Xin Yang, Xin-Hui Su, Zhen Zeng, Yao Fan, Yuan Wu, Li-Li Guo, Xiao-Yan Xu
Xin Yang, Xin-Hui Su, Zhen Zeng, Yao Fan, Yuan Wu, Li-Li Guo, Xiao-Yan Xu, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Yang X and Su XH performed the conception and design; Zeng Z and Guo LL performed the development of methodology; Fan Y and Wu Y contributed to the analysis and interpretation of data; Yang X and Su XH contributed to the writing and review of the manuscript; Xu XY performed the study supervision; Yang X and Su XH contributed equally to this work; all authors had final approval of the submitted versions.
Supported by Key Research and Development Plan Projects in Hubei Province, No. 2022BCA041; and National Natural Science Foundation of China, No. 82101277.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (No. TJ-IRB20230736).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Yan Xu, PhD, Doctor, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. xuxiaoyan@tjh.tjmu.edu.cn
Received: July 9, 2023
Peer-review started: July 9, 2023
First decision: August 17, 2023
Revised: August 29, 2023
Accepted: September 28, 2023
Article in press: September 28, 2023
Published online: October 26, 2023
Processing time: 106 Days and 15.6 Hours
Abstract
BACKGROUND

Persistent left superior vena cava (PLSVC) is the most common venous system variant. The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.

AIM

To develop reliable prenatal diagnostic recommendations through integrated analysis of the clinical characteristics of fetuses with PLSVC.

METHODS

Cases of PLSVC diagnosed using prenatal ultrasonography between September 2019 and November 2022 were retrospectively studied. The clinical characteristics of the pregnant women, ultrasonic imaging information, gestational age at diagnosis, pregnancy outcomes, and amniocentesis results were summarized and analyzed using categorical statistics and the chi-square test or Fisher’s exact test.

RESULTS

Of the 97 cases diagnosed by prenatal ultrasound, 49 (50.5%) had isolated PLSVC and 48 (49.5%) had other structural abnormalities. The differences in pregnancy outcomes and amniocentesis conditions between the two groups were statistically significant (P < 0.05). No significant differences were identified between the two groups in terms of advanced maternal age and gestational age (P > 0.05). According to the results of the classification statistics, the most common intracardiac abnormality was a ventricular septal defect and the most common extracardiac abnormality was a single umbilical artery. In the subgroup analysis, the concurrent combination of intra- and extracardiac structural abnormalities was a risk factor for adverse pregnancy outcomes (odds ratio > 1, P < 0.05). Additionally, all abnormal cytogenetic findings on amniocentesis were observed in the comorbidity group. One case was diagnosed with 21-trisomy and six cases was diagnosed with chromosome segment duplication.

CONCLUSION

Examination for other structural abnormalities is strongly recommended when PLSVC is diagnosed. Poorer pregnancy outcomes and increased amniocentesis were observed in PLSVC cases with other structural abnormalities. Amniotic fluid cytogenetics of fetuses is recommended for PLSVC with other structural abnormalities.

Keywords: Persistent left superior vena cava; Prenatal diagnosis; Amniotic fluid cytogenetics; Pregnancy outcome; Integrated analysis; Comorbidity

Core Tip: Our study was performed for providing reliable prenatal diagnostic advice through integrated analysis of the clinical characteristics of fetuses with persistent left superior vena cava (PLSVC). We retrospectively studied 97 cases of PLSVC diagnosed using prenatal ultrasonography. Of the 97 cases diagnosed by prenatal ultrasound, 49 (50.5%) had isolated PLSVC and 48 (49.5%) had other structural abnormalities. We found that PLSVC is associated with a certain percentage of other combined structural abnormalities. Examination for other structural abnormalities is strongly recommended when PLSVC is diagnosed. Poorer pregnancy outcomes and increased amniocentesis were observed in PLSVC cases with other structural abnormalities.