OC01.01: Foramen ovale morphology at fetal echocardiography may predict neonatal outcome in fetuses with complete transposition of the great arteries

Objectives: To predict neonatal outcome in cases with complete transposition of the great arteries (TGA) basing on foramen ovale (FO) morphology at fetal echocardiography. The primary outcome was the necessity of urgent Rashkind procedure. Methods: This was a retrospective cohort study. Patients referred to our tertiary centre for suspected complete TGA in a 12‐year period.The following parameters were systematically obtained at fetal echocardiography at 34–37 weeks: presence of restrictive (FO), FO diameter, right atrium diameter. Neonatal follow‐up was obtained through medical records analysis. Results: From November 2007 to April 2019, 71 fetuses with complete TGA were referred to our echocardiography laboratory. Of these, three were lost at follow up. Of the 68 remaining cases, 31 underwent urgent Rashkind procedure, 22 elective Rashkind procedure and 15 no procedure. Cases with restrictive FO had a significantly higher risk of urgent Rashking procedure compared with cases with normal FO (p below 0.05). Cases with smaller FO diameter and larger right atrium at fetal echocardiography had a significantly increased risk of urgent Rashkind procedure (p below 0.05). Conclusions: In cases with complete TGA a restrictive or narrow FO and a large right atrium at fetal echocardiography are associated with a worse neonatal outcome.