{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:46:49Z","timestamp":1791229609666,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,2]],"date-time":"2020-01-02T00:00:00Z","timestamp":1577923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To review the pathophysiology of rhabdomyomas and the emerging option of prenatal treatment of fetal cardiac rhabdomyomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We present a case of fetal rhabdomyomas causing significant hemodynamic compromise that received in utero treatment of maternal sirolimus. Genetic amniocentesis confirmed a\n                      <jats:italic>TSC2<\/jats:italic>\n                      mutation. A treatment program was initiated with a 10\u2010mg loading dose titrated to a goal maternal trough of 10 to 15 ng\/dL. In order to follow fetal cardiac function, a sophisticated method of speckle tracking echocardiography was used before and after treatment. Obstetric ultrasound was used to monitor fetal growth, and clinical surveillance, echocardiography, and brain MRI were used to monitor postnatal growth and development through 6 months of neonatal life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sirolimus was initiated from 28 to 36 weeks of gestation with improvement of cardiac status. During this period, intrauterine growth restriction developed. Postnatally, the infant has had stable rhabdomyomas and cardiac function without reinitiating sirolimus. Brain MRI demonstrated scattered cortical tubers and subependymal nodules, and the infant has not had seizure\u2010like activity. At 6 months of age, the infant has achieved appropriate developmental milestones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In counseling cases of prenatal onset large obstructing rhabdomyomas and cardiac compromise, in utero sirolimus treatment can be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.5613","type":"journal-article","created":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T12:57:58Z","timestamp":1574168278000},"page":"358-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Fetal cardiac rhabdomyomas treated with maternal sirolimus"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4891-3354","authenticated-orcid":false,"given":"Ilina D.","family":"Pluym","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California at Los Angeles  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sklansky","sequence":"additional","affiliation":[{"name":"Department of Pediatrics UCLA, Mattel Children's Hospital, David Geffen School of Medicine at UCLA  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce Y.","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics University of California at Los Angeles  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalda","family":"Afshar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California at Los Angeles  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Holliman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California at Los Angeles  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-572X","authenticated-orcid":false,"given":"Greggory R.","family":"Devore","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California at Los Angeles  Los Angeles CA"},{"name":"Fetal Diagnostic Centers  Pasadena CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayanna","family":"Walden","sequence":"additional","affiliation":[{"name":"Walden OBGYN  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence D.","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California at Los Angeles  Los Angeles CA"},{"name":"Center for Fetal Medicine and Women's Ultrasound  Los Angeles 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