Integrated management and prognosis analysis of 30 cases of fetal pulmonary valve abnormalities during pregnancy and perinatal period

Integrated management and prognosis analysis of 30 cases of fetal pulmonary valve abnormalities during pregnancy and perinatal period | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Integrated management and prognosis analysis of 30 cases of fetal pulmonary valve abnormalities during pregnancy and perinatal period Junshu Xie, Xiuju Yin, Qiuyan Pei, Lihuang Yan, Lin Zhang, Jie Liu, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4203532/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective This study aims to investigate prenatal testing, integrated management methods, and the prognosis of fetal pulmonary valve abnormalities (PVA) detected by ultrasound during pregnancy. Methods A retrospective analysis was conducted on the integrated perinatal management and prognosis of 30 fetal PVA cases identified during pregnancy by ultrasound at Peking University People's Hospital from January 2019 to March 2023. Results The incidence of fetal PVA diagnosed by prenatal ultrasound during the study period was 0.25% (30/11,923). Among the 30 PVA fetuses, 6 (20.0%) had pulmonary valve atresia with intact ventricular septum (PA/IVS), and 24 (80%) had pulmonary valve stenosis (PS). Of the 6 PA/IVS fetuses, 5 (5/6) had no abnormalities detected via prenatal diagnosis, and 1 did not undergo prenatal diagnosis. Four (4/6) PA/IVS patients were delivered by Caesarean section (CS) at an average gestational week of (38.1 ± 1.2) weeks and an average birth weight of (3172.5 ± 265.5) g. All of them received alprostadil intravenous pumping (6.00~13.00 ng/min/kg) after birth, followed by transthoracic balloon (pulmonary) valvuloplasty(TBV) + modified Blalock-Taussig shunt (BT) + ligation of Ductus arteriosus within an average of (4.5 ± 1.7) days. All patients recovered well after follow-up. Among the 24 patients with PS, 4 had severe PS (4/24), 20 had mild PS (20/24), and 1 had SNP abnormalities (1/24). Of the 24 patients, 7 (7/24) opted for pregnancy termination. Among the 17 (17/24) PS patients who delivered, 7 (7/17) had spontaneous labor, 1 (1/17) had forceps, and 9 (9/17) had CS. The average gestational week of delivery was (37.8 ± 1.0) weeks, and the average birth weight of newborns was (3288.8 ± 404.6) g. Three (3/17) severe PS neonates underwent TBV+ modified BT + ligation of Ductus arteriosus within 7 days after birth and recovered well after follow-up. Among 14 mild PS patients (14/17), 1 died within 1 week after birth (1/14). Two cases (2/14) underwent surgical treatment and recovered well. Seven cases (7/14) diagnosed with fetal mild PS did not require surgical treatment after birth. Four cases (4/14) did not detect PS by echocardiography after birth. The positive predictive value of prenatal ultrasound diagnosis for mild PS is 71.4%. Conclusion For PVA fetuses identified by ultrasound during pregnancy, it is recommended to conduct chromosomal karyotype analysis and SNP-array, and make an individualized evaluation and management based on the condition of fetal PVA and related abnormalities. The mode of delivery can be selected according to the obstetric situation. When necessary, newborns should be administered alprostadil to keep the ductus arteriosus open and be timely transferred to pediatric cardiac surgery for surgery. If the newborns do not experience any other complications after birth, surgery can achieve a good prognosis. Pulmonary valve stenosis Pulmonary valve atresia Ultrasonography Prenatal diagnosis Perinatal integrated management Full Text Supplementary Files PVAaddstotheclinicalworktakehomemessage.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4203532","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":287425699,"identity":"9eb9f55c-5f86-4b57-86ea-98c2c2009eda","order_by":0,"name":"Junshu Xie","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Junshu","middleName":"","lastName":"Xie","suffix":""},{"id":287425700,"identity":"3a0e6914-3d82-4f99-9717-f89d1dc4a057","order_by":1,"name":"Xiuju Yin","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Xiuju","middleName":"","lastName":"Yin","suffix":""},{"id":287425701,"identity":"5fb62dac-21a4-46ff-b654-77ca69cb2ad9","order_by":2,"name":"Qiuyan Pei","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Qiuyan","middleName":"","lastName":"Pei","suffix":""},{"id":287425702,"identity":"4143ef9b-f28f-4546-8a7b-f42b7accbb34","order_by":3,"name":"Lihuang Yan","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Lihuang","middleName":"","lastName":"Yan","suffix":""},{"id":287425703,"identity":"6dbc0f1b-dbec-4e26-96a7-5c66737e914f","order_by":4,"name":"Lin Zhang","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Zhang","suffix":""},{"id":287425704,"identity":"df4366c5-a905-46db-b32e-6ed1a6c52cc2","order_by":5,"name":"Jie Liu","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Jie","middleName":"","lastName":"Liu","suffix":""},{"id":287425705,"identity":"26cf4d82-976d-4ee8-81ef-8dc7fda5db24","order_by":6,"name":"Huili Zhang","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Huili","middleName":"","lastName":"Zhang","suffix":""},{"id":287425706,"identity":"9029985b-bd70-4810-9a0b-d752608717ad","order_by":7,"name":"Xiaohong Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIie2QPQvCMBCGDw6qQ0o2qTj0L5x0cfDHpHsVoXsXoZM4W8T/0NExkqFLwbXgUhDchIwdTTenfmyCeZZw8D7cvQGwWH4RBCDzCECUUjejlEka3rLDiGUCWBmoqTMgSgXK2L0mW6oirYCBz2eyW5nvHRG4pYqp2uRqt4JldhbdCkdGgZvKMG+VEwNBjx7FQa6NkhglqhVzBihmCxgFw7wsYZhiutDykqowK1Iyn+z1d6G7etHbHHZU+NS6Wft80aO0dehr8HrjLVgPilksFsv/8gH4S0YiiR9n6wAAAABJRU5ErkJggg==","orcid":"","institution":"Peking University People's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Xiaohong","middleName":"","lastName":"Zhang","suffix":""}],"badges":[],"createdAt":"2024-04-02 03:30:47","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4203532/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4203532/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":54867552,"identity":"0598e466-c79f-4d3a-823f-cd3af53b43ae","added_by":"auto","created_at":"2024-04-17 21:50:41","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":433724,"visible":true,"origin":"","legend":"","description":"","filename":"PAfinalrevision329.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4203532/v1_covered_980e7254-912e-426a-9939-6a7ee59df8dc.pdf"},{"id":54351302,"identity":"957db9ca-95ec-49fb-92fa-4bca86f9471d","added_by":"auto","created_at":"2024-04-09 08:36:38","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":15028,"visible":true,"origin":"","legend":"","description":"","filename":"PVAaddstotheclinicalworktakehomemessage.docx","url":"https://assets-eu.researchsquare.com/files/rs-4203532/v1/7da2431ce670552f8cd011f4.docx"}],"financialInterests":"","formattedTitle":"Integrated management and prognosis analysis of 30 cases of fetal pulmonary valve abnormalities during pregnancy and perinatal period","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Pulmonary valve stenosis, Pulmonary valve atresia, Ultrasonography, Prenatal diagnosis, Perinatal integrated management","lastPublishedDoi":"10.21203/rs.3.rs-4203532/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4203532/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Objective\n\nThis study aims to investigate prenatal testing, integrated management methods, and the prognosis of fetal pulmonary valve abnormalities (PVA) detected by ultrasound during pregnancy.\n\nMethods\n\nA retrospective analysis was conducted on the integrated perinatal management and prognosis of 30 fetal PVA cases identified during pregnancy by ultrasound at Peking University People's Hospital from January 2019 to March 2023.\n\nResults\n\nThe incidence of fetal PVA diagnosed by prenatal ultrasound during the study period was 0.25% (30/11,923). Among the 30 PVA fetuses, 6 (20.0%) had pulmonary valve atresia with intact ventricular septum (PA/IVS), and 24 (80%) had pulmonary valve stenosis (PS). Of the 6 PA/IVS fetuses, 5 (5/6) had no abnormalities detected via prenatal diagnosis, and 1 did not undergo prenatal diagnosis. Four (4/6) PA/IVS patients were delivered by Caesarean section (CS) at an average gestational week of (38.1 ± 1.2) weeks and an average birth weight of (3172.5 ± 265.5) g. All of them received alprostadil intravenous pumping (6.00~13.00 ng/min/kg) after birth, followed by transthoracic balloon (pulmonary) valvuloplasty(TBV) + modified Blalock-Taussig shunt (BT) + ligation of Ductus arteriosus within an average of (4.5 ± 1.7) days. All patients recovered well after follow-up. Among the 24 patients with PS, 4 had severe PS (4/24), 20 had mild PS (20/24), and 1 had SNP abnormalities (1/24). Of the 24 patients, 7 (7/24) opted for pregnancy termination. Among the 17 (17/24) PS patients who delivered, 7 (7/17) had spontaneous labor, 1 (1/17) had forceps, and 9 (9/17) had CS. The average gestational week of delivery was (37.8 ± 1.0) weeks, and the average birth weight of newborns was (3288.8 ± 404.6) g. Three (3/17) severe PS neonates underwent TBV+ modified BT + ligation of Ductus arteriosus within 7 days after birth and recovered well after follow-up. Among 14 mild PS patients (14/17), 1 died within 1 week after birth (1/14). Two cases (2/14) underwent surgical treatment and recovered well. Seven cases (7/14) diagnosed with fetal mild PS did not require surgical treatment after birth. Four cases (4/14) did not detect PS by echocardiography after birth. The positive predictive value of prenatal ultrasound diagnosis for mild PS is 71.4%.\n\nConclusion\n\nFor PVA fetuses identified by ultrasound during pregnancy, it is recommended to conduct chromosomal karyotype analysis and SNP-array, and make an individualized evaluation and management based on the condition of fetal PVA and related abnormalities. The mode of delivery can be selected according to the obstetric situation. When necessary, newborns should be administered alprostadil to keep the ductus arteriosus open and be timely transferred to pediatric cardiac surgery for surgery. If the newborns do not experience any other complications after birth, surgery can achieve a good prognosis.","manuscriptTitle":"Integrated management and prognosis analysis of 30 cases of fetal pulmonary valve abnormalities during pregnancy and perinatal period","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-09 08:36:33","doi":"10.21203/rs.3.rs-4203532/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"efa83203-df88-4953-96fb-f6f6dd89dcd4","owner":[],"postedDate":"April 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-04-17T21:42:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-09 08:36:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4203532","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4203532","identity":"rs-4203532","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}