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Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy

We aimed to evaluate the usefulness of three-dimensional (3D) reconstruction of histology slides to confirm congenital heart disease (CHD) detected by first-trimester fetal cardiac ultrasonography. Conventional autopsy is hindered by the small size of the first-trimester fetal heart, and current CHD...

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Autores principales: Ruican, Dan, Petrescu, Ana-Maria, Istrate-Ofiţeru, Anca-Maria, Roșu, Gabriela Camelia, Zorilă, George-Lucian, Dîră, Laurenţiu Mihai, Nagy, Rodica Daniela, Mogoantă, Laurenţiu, Pirici, Daniel, Iliescu, Dominic Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184816/
https://www.ncbi.nlm.nih.gov/pubmed/37141594
http://dx.doi.org/10.1097/AOG.0000000000005169
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author Ruican, Dan
Petrescu, Ana-Maria
Istrate-Ofiţeru, Anca-Maria
Roșu, Gabriela Camelia
Zorilă, George-Lucian
Dîră, Laurenţiu Mihai
Nagy, Rodica Daniela
Mogoantă, Laurenţiu
Pirici, Daniel
Iliescu, Dominic Gabriel
author_facet Ruican, Dan
Petrescu, Ana-Maria
Istrate-Ofiţeru, Anca-Maria
Roșu, Gabriela Camelia
Zorilă, George-Lucian
Dîră, Laurenţiu Mihai
Nagy, Rodica Daniela
Mogoantă, Laurenţiu
Pirici, Daniel
Iliescu, Dominic Gabriel
author_sort Ruican, Dan
collection PubMed
description We aimed to evaluate the usefulness of three-dimensional (3D) reconstruction of histology slides to confirm congenital heart disease (CHD) detected by first-trimester fetal cardiac ultrasonography. Conventional autopsy is hindered by the small size of the first-trimester fetal heart, and current CHD confirmation studies employ the use of highly specialized and expensive methods. TECHNIQUE: An extended first-trimester ultrasound examination protocol was used to diagnose fetal heart anomalies. Medical termination of pregnancies was followed by fetal heart extraction. The specimens were sliced, and the histology slides were stained and scanned. The resulting images were processed, and volume rendering was performed using 3D reconstruction software. The volumes were analyzed by a multidisciplinary team of maternal–fetal medicine subspecialists and pathologists and compared with ultrasound examination findings. EXPERIENCE: Six fetuses with heart malformations were evaluated using histologic 3D imaging: two with hypoplastic left heart syndrome, two with atrioventricular septal defects, one with an isolated ventricular septal defect, and one with transposition of the great arteries. The technique allowed us to confirm ultrasound-detected anomalies and also identified additional malformations. CONCLUSION: After pregnancy termination or loss, histologic 3D imaging can be used to confirm the presence of fetal cardiac malformations detected during first-trimester ultrasound examination. Additionally, this technique has the potential to refine the diagnosis for counseling regarding recurrence risk and retains the advantages of standard histology.
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spelling pubmed-101848162023-05-16 Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy Ruican, Dan Petrescu, Ana-Maria Istrate-Ofiţeru, Anca-Maria Roșu, Gabriela Camelia Zorilă, George-Lucian Dîră, Laurenţiu Mihai Nagy, Rodica Daniela Mogoantă, Laurenţiu Pirici, Daniel Iliescu, Dominic Gabriel Obstet Gynecol Procedures and Instruments We aimed to evaluate the usefulness of three-dimensional (3D) reconstruction of histology slides to confirm congenital heart disease (CHD) detected by first-trimester fetal cardiac ultrasonography. Conventional autopsy is hindered by the small size of the first-trimester fetal heart, and current CHD confirmation studies employ the use of highly specialized and expensive methods. TECHNIQUE: An extended first-trimester ultrasound examination protocol was used to diagnose fetal heart anomalies. Medical termination of pregnancies was followed by fetal heart extraction. The specimens were sliced, and the histology slides were stained and scanned. The resulting images were processed, and volume rendering was performed using 3D reconstruction software. The volumes were analyzed by a multidisciplinary team of maternal–fetal medicine subspecialists and pathologists and compared with ultrasound examination findings. EXPERIENCE: Six fetuses with heart malformations were evaluated using histologic 3D imaging: two with hypoplastic left heart syndrome, two with atrioventricular septal defects, one with an isolated ventricular septal defect, and one with transposition of the great arteries. The technique allowed us to confirm ultrasound-detected anomalies and also identified additional malformations. CONCLUSION: After pregnancy termination or loss, histologic 3D imaging can be used to confirm the presence of fetal cardiac malformations detected during first-trimester ultrasound examination. Additionally, this technique has the potential to refine the diagnosis for counseling regarding recurrence risk and retains the advantages of standard histology. Lippincott Williams & Wilkins 2023-06 2023-05-03 /pmc/articles/PMC10184816/ /pubmed/37141594 http://dx.doi.org/10.1097/AOG.0000000000005169 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Procedures and Instruments
Ruican, Dan
Petrescu, Ana-Maria
Istrate-Ofiţeru, Anca-Maria
Roșu, Gabriela Camelia
Zorilă, George-Lucian
Dîră, Laurenţiu Mihai
Nagy, Rodica Daniela
Mogoantă, Laurenţiu
Pirici, Daniel
Iliescu, Dominic Gabriel
Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy
title Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy
title_full Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy
title_fullStr Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy
title_full_unstemmed Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy
title_short Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy
title_sort confirmation of heart malformations in fetuses in the first trimester using three-dimensional histologic autopsy
topic Procedures and Instruments
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184816/
https://www.ncbi.nlm.nih.gov/pubmed/37141594
http://dx.doi.org/10.1097/AOG.0000000000005169
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