Nuchal translucency and congenital heart defects: heart failure or not?

Objective To determine whether heart failure is the mechanism underlying th e association between increased fetal nuchal translucency and congenital he art defects. Methods Retrospective analysis of the types of congenital heart defect obse rved in fetuses with increased nuchal translucency and those with normal nu chal scans. Retrospective quantitative analysis of cardiac size and left ve ntricular ejection fraction in fetuses with ventricular septal defects or t he hypoplastic left heart syndrome. Results Eighty-three fetuses with congenital heart defects had undergone nu chal screening of which 51 had increased nuchal translucency and 32 had nor mal nuchal translucency. A wide variety of different congenital cardiac les ions with different hemodynamic effects were observed in fetuses with incre ased nuchal translucency and those with normal nuchal scans. Defects primar ily characterized by left heart obstruction, right heart obstruction and se ptal defects occurred in both groups. all measurements of cardiothoracic ra tio and left ventricular ejection fraction fell within the normal range and there was no significant difference between fetuses with increased nuchal translucency and those with normal nuchal scans. Conclusions No specific type of congenital heart lesion is associated with increased nuchal translucency. The contention that heart failure explains t he association between congenital heart defects and increased nuchal transl ucency is not supported by this study.