Prenatal diagnosis and postnatal outcome of cardiac rhabdomyomas

Aims: To evaluate the sonographic appearance of suspeered fetal cardiac rhabdomyomas and their evolution until delivery and in the postnatal period. Methods: The study group consisted of 6 patients at 23-37weeks of gestation referred to our Ultrasonic Unit, between March 1992 and December 1998, for suspected fetal cardiac rhabdomyomas. Results: The cardiac tumors were single in three cases and multiple in the other cases. The size ranged from 11 to 47 mm. In two cases the tumors arose from the right ventricle, in one case from the interventricular septum and in three cases from the left ventricle. Five infants arc alive and in satisfactory hemodynamic compensation, but three of them developed tuberous sclerosis In two infants a regression in the maximum diameter of the tumor masses has been observed. One child underwent surgical treatment at the age of six months and the baby died after surgery. Conclusions: Two-dimensional and Doppler echocardiography are useful non invasive methods to diagnose fetal cardiac rhabdomyomas and to monitor their influence on the fetal cardiac function. I However they do not allow us to recognize which fetuses presenting with features compatible with rhabdomyomas will develop tuberous sclerosis.