{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T10:00:41Z","timestamp":1785578441988,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"ABSTRACT<\/jats:title>\n \n Purpose<\/jats:title>\n Cardiac rhabdomyoma, the most common fetal cardiac tumor, is frequently associated with tuberous sclerosis complex (TSC). This study examined pre\u2010 and postnatal factors affecting mortality in fetal cardiac rhabdomyoma (FCR) and explored links between TSC and clinical features.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic review was conducted in July 2023 using Medline, Web of Science, Embase, and Cochrane Library to identify reported FCR cases. Analyses were performed on two sample groups (A and B).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Neonatal mortality was significantly associated with hydrops (\n p<\/jats:italic>\n \u2009<\u20090.001), tumor progression (\n p<\/jats:italic>\n \u2009<\u20090.001), fetal heart failure (\n p<\/jats:italic>\n \u2009<\u20090.001), and fetal growth restriction (FGR) (\n p<\/jats:italic>\n \u2009=\u20090.021). Hydrops was the strongest predictor of mortality (Sample A: RR 17.2,\n p<\/jats:italic>\n \u2009=\u20090.027; Sample B: RR 12.2,\n p<\/jats:italic>\n \u2009=\u20090.006). Among 683 cases, 73% were diagnosed with TSC. Multiple tumors increased the likelihood of TSC (Sample A: RR 4.8,\n p<\/jats:italic>\n \u2009<\u20090.0001; Sample B: RR 3,\n p<\/jats:italic>\n \u2009=\u20090.015). In postnatal factors, preterm delivery (\n p<\/jats:italic>\n \u2009<\u20090.001), cardiac arrhythmia (\n p<\/jats:italic>\n \u2009=\u20090.001), and heart failure (\n p<\/jats:italic>\n \u2009<\u20090.001) were also linked to mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Hydrops is the strongest mortality predictor in FCR. Multiple tumors are associated with TSC. In prenatal factors, tumor progression, fetal heart failure, and FGR were associated with increased mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcu.70359","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:49:48Z","timestamp":1785577788000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Affecting Pregnancy Outcomes in Fetal Cardiac Rhabdomyoma: A Systematic Review and Analysis of 859 Cases"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3244-3565","authenticated-orcid":false,"given":"Fahimeh","family":"Azizinik","sequence":"first","affiliation":[{"name":"Department of Radiology, School of Medicine, Yas Women Hospital Tehran University of Medical Sciences Tehran Iran"},{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2698-4872","authenticated-orcid":false,"given":"Behnaz","family":"Moradi","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Yas Women Hospital Tehran University of Medical Sciences Tehran Iran"},{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razieh","family":"Mohammadi\u2010Dashtaki","sequence":"additional","affiliation":[{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shima","family":"karbasi","sequence":"additional","affiliation":[{"name":"School of Medicine Isfahan University of Medical Sciences (MUI) Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5411-0809","authenticated-orcid":false,"given":"Nima Broomand","family":"Lomer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-5549","authenticated-orcid":false,"given":"Mohammad","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"School of Medicine Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6624-2342","authenticated-orcid":false,"given":"Mobin","family":"Fathy","sequence":"additional","affiliation":[{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Rahmannia","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7839-4685","authenticated-orcid":false,"given":"Hamed","family":"Ghorani","sequence":"additional","affiliation":[{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"},{"name":"Department of Radiology, Shariati Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2285-425X","authenticated-orcid":false,"given":"Maedeh","family":"Mohaghegh","sequence":"additional","affiliation":[{"name":"Department of Science and Biological Technology North Tehran Branch of Islamic Azad University Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-7827","authenticated-orcid":false,"given":"Fatemeh Shakki","family":"Katouli","sequence":"additional","affiliation":[{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"},{"name":"Department of Radiology, School of Medicine, Arash Women Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3751-733X","authenticated-orcid":false,"given":"Parham Talebi","family":"Boroujeni","sequence":"additional","affiliation":[{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Allan L. 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S.","year":"2003","journal-title":"Journal of Pediatrics"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S0301-2115(01)00337-2","article-title":"Fetal Intracardiac Tumor (s): Prenatal Diagnosis and Management: Three Case Reports","volume":"99","author":"Bonnamy L.","year":"2001","journal-title":"European Journal of Obstetrics, Gynecology, and Reproductive Biology"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/TACG.S90262","article-title":"Genetics of Tuberous Sclerosis Complex: Implications for Clinical Practice","volume":"10","author":"Caban C.","year":"2017","journal-title":"Application of Clinical Genetics"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/uog.5264","article-title":"Outcome of Antenatally Diagnosed Cardiac Rhabdomyoma: Case Series and a Meta\u2010Analysis","volume":"31","author":"Chao A.","year":"2008","journal-title":"Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/00000433-199612000-00001","article-title":"Primary Cardiac Tumors Causing Sudden Death: A Review of the Literature","volume":"17","author":"Cina S. J.","year":"1996","journal-title":"American Journal of Forensic Medicine and Pathology"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1353\/wp.1996.0023","article-title":"Insights and Pitfalls: Selection Bias in Qualitative Research","volume":"49","author":"Collier D.","year":"1996","journal-title":"World Politics"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(08)61279-9","article-title":"Tuberous Sclerosis","volume":"372","author":"Curatolo P.","year":"2008","journal-title":"Lancet"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.crwh.2018.e00070","article-title":"Prenatal Diagnosis of Fetal Cardiac Rhabdomyoma Associated With Tuberous Sclerosis: A Case Report","volume":"19","author":"Ekmekci E.","year":"2018","journal-title":"Case Reports in Women's Health"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","DOI":"10.3390\/cells10112923","article-title":"Cardiac Conduction Velocity, Remodeling and Arrhythmogenesis","volume":"10","author":"Han B.","year":"2021","journal-title":"Cells"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s00246-003-0590-4","article-title":"Fetal and Neonatal Cardiac Tumors","volume":"25","author":"Isaacs H.","year":"2004","journal-title":"Pediatric Cardiology"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2025.1711774","article-title":"Fetal Cardiac Rhabdomyomas Susceptible to Prenatal Treatment With mTOR Inhibitors: Literature Review and Proposal of a Prenatal Management Algorithm","volume":"12","author":"Martinez\u2010Garcia A.","year":"2025","journal-title":"Frontiers in Medicine"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1016\/j.jacc.2011.08.005","article-title":"Cardiac Tumors and Associated Arrhythmias in Pediatric Patients, With Observations on Surgical Therapy for Ventricular Tachycardia","volume":"58","author":"Miyake C. Y.","year":"2011","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_11_16_1","first-page":"289","article-title":"Tuberous Sclerosis: Clinical Characteristics and Their Relationship to Genotype\/Phenotype","volume":"81","author":"Monteiro T.","year":"2014","journal-title":"Anales de Pediatr\u00eda"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/ije\/dyx206","article-title":"Collider Scope: When Selection Bias Can Substantially Influence Observed Associations","volume":"47","author":"Munaf\u00f2 M. R.","year":"2018","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2025.1649341","article-title":"Drug Review: mTOR\u2010Inhibitor Therapy in Fetal Cardiac Rhabdomyoma\u2010a Tightrope Walk","volume":"13","author":"Muschel N.","year":"2025","journal-title":"Frontiers in Pediatrics"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12881-015-0155-4","article-title":"Targeted Next Generation Sequencing Reveals Previously Unidentified TSC1 and TSC2 Mutations","volume":"16","author":"Nellist M.","year":"2015","journal-title":"BMC Medical Genetics"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.pediatrneurol.2021.07.011","article-title":"Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations","volume":"123","author":"Northrup H.","year":"2021","journal-title":"Pediatric Neurology"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.pediatrneurol.2013.08.001","article-title":"Tuberous Sclerosis Complex Diagnostic Criteria Update: Recommendations of the 2012 Iinternational Tuberous Sclerosis Complex Consensus Conference","volume":"49","author":"Northrup H.","year":"2013","journal-title":"Pediatric Neurology"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.1749-6632.2009.05117.x","article-title":"The Tuberous Sclerosis Complex","volume":"1184","author":"Orlova K. 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B.Shea D.O'Connell et\u00a0al.2000.The Newcastle\u2010Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses."},{"key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.pedneo.2016.07.004","article-title":"Fetal Primary Cardiac Tumors During Perinatal Period","volume":"58","author":"Yuan S.\u2010M.","year":"2017","journal-title":"Pediatrics and Neonatology"}],"container-title":["Journal of Clinical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70359","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcu.70359","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:49:57Z","timestamp":1785577797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcu.70359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":30,"alternative-id":["10.1002\/jcu.70359"],"URL":"https:\/\/doi.org\/10.1002\/jcu.70359","archive":["Portico"],"relation":{},"ISSN":["0091-2751","1097-0096"],"issn-type":[{"value":"0091-2751","type":"print"},{"value":"1097-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"assertion":[{"value":"2025-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jcu.70359"}}