Urgent neonatal balloon atrial septostomy in simple transposition of the great arteries: predictive value of fetal cardiac parameters.

Simple TGA fetuses exhibited cardiac remodelling at term with more profound alterations in these cardiac parameters after birth suggestive of adaptation to abnormal loading conditions and possible adaptive responses to hypoxemia. Perinatal adaptation in TGA might reflect persistence of the abnormal parallel arrangement of cardiovascular circulation and presence of widely patent fetal shunts imposing volume load on the neonatal heart. The fetal cardiac parameters that showed high predictive values for urgent BAS in TGA neonates might reflect the impact of late-gestation pathophysiology and progressive hypoxemia on fetal cardiac geometry and function. If these findings are validated in larger prospective studies, the detailed cardiac assessment of TGA fetuses near term could facilitate improvement of perinatal management and refining the timing of postnatal intervention strategies to prevent adverse pregnancy outcome. This article is protected by copyright. All rights reserved.