{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:52:18Z","timestamp":1791129138127,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To describe the pregnancy and postnatal outcomes of a large, retrospectively analyzed case\u2013cohort series of pregnancies complicated by congenital heart disease (CHD) and fetal hydrops that were assessed for potential for fetal cardiac intervention (FCI).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The International Fetal Cardiac Intervention Registry (IFCIR) collects diagnostic and procedure\u2010related data on maternal\u2013fetal dyads with CHD that are considered by fetal specialists to be potentially capable of benefiting from FCI, with data submitted voluntarily by local institutions. For this retrospective analysis, the IFCIR database was searched for all case entries of pregnancies with a diagnosis of CHD and coexistent non\u2010immune fetal hydrops, defined as abnormal fluid or edema involving at least two compartments, between January 2001 and September 2024. Data on the underlying cardiac diagnosis, procedures performed and pregnancy and postnatal outcomes were collated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At the time of data extraction, the IFCIR contained 864 recorded maternal\u2013fetal dyads, of which 91 (10.5%) had fetal hydrops at initial evaluation. Of these, 73 (80.2%) underwent FCI, including aortic (\n n<\/jats:italic>\n \u2009=\u200961) or pulmonary (\n n<\/jats:italic>\n \u2009=\u20095) balloon valvuloplasty, atrial septal intervention and\/or stent placement (\n n<\/jats:italic>\n \u2009=\u20094) and other FCI (\n n<\/jats:italic>\n \u2009=\u20093), at a median gestational age of 28.3 (range, 19.6\u201334.7)\u2009weeks. The overall rate of procedure\u2010related fetal loss was 20.5% (15\/73). There were an additional 10 intrauterine fetal deaths, and two cases were either terminated (\n n<\/jats:italic>\n \u2009=\u20091) or lost to follow\u2010up (\n n<\/jats:italic>\n \u2009=\u20091). Overall, 21 neonates were liveborn preterm (<\u200937\u2009weeks) and 25 were liveborn at term (\u2265\u200937\u2009weeks), with a median latency post\u2010procedure to delivery of 8.9 (range, 0.3\u201318.4)\u2009weeks. Of the 73 cases that underwent FCI, 26 (35.6%) survived to first hospital discharge, including 39.3% (24\/61) of patients who underwent aortic valvuloplasty, one patient who underwent atrial septal intervention and one patient who underwent pulmonary valvuloplasty. The majority of survivors had biventricular circulation (15\/20 with available outcome) at the last follow\u2010up. No procedure\u2010related maternal complications were recorded. Only 1\/18 patients managed expectantly without FCI survived to hospital discharge.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our findings suggest a potential benefit of FCI in patients with hydrops, although the procedure\u2010related loss rate of 1 in 5 was significant. While the survival rate was lower than that reported in non\u2010hydropic cohorts with FCI, approximately one\u2010third of hydropic fetuses that underwent FCI included in our analysis survived to hospital discharge. \u00a9 2026 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.70245","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:35:27Z","timestamp":1781242527000},"page":"99-106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Invasive\n in\u2010utero<\/i>\n cardiac intervention in the hydropic fetus may improve survival: results from the International Fetal Cardiac Intervention Registry (\n IFCIR<\/scp>\n )"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-693X","authenticated-orcid":false,"given":"A. J.","family":"Moon\u2010Grady","sequence":"first","affiliation":[{"name":"UCSF Benioff Children's Hospital, Department of Pediatrics, Division of Cardiology University of California San Francisco San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tulzer","sequence":"additional","affiliation":[{"name":"Children's Heart Center Linz, Department of Pediatric Cardiology Kepler University Hospital Linz Austria"},{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4534-5075","authenticated-orcid":false,"given":"A. K.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"The Heart Center, Nationwide Children's Hospital Columbus OH USA"},{"name":"The Congenital Heart Collaborative Rainbow Babies and Children's Hospital Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-866X","authenticated-orcid":false,"given":"R.","family":"Cruz\u2010Martinez","sequence":"additional","affiliation":[{"name":"Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico Queretaro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-0882","authenticated-orcid":false,"given":"B.","family":"Cuneo","sequence":"additional","affiliation":[{"name":"University of Colorado Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Dangel","sequence":"additional","affiliation":[{"name":"Department of Perinatal Cardiology and Congenital Anomalies Centre of Postgraduate Medical Education Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1308-1474","authenticated-orcid":false,"given":"A.","family":"Galindo","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Obstetrics and Gynecology Department, Hospital Universitario 12 de Octubre, Complutense University Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n del Hospital 12 de Octubre (imas12) Madrid Spain"},{"name":"Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS\u2010SAMID network), RD21\/0012\/0024 Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9436-4897","authenticated-orcid":false,"given":"H.","family":"Gardiner","sequence":"additional","affiliation":[{"name":"The Fetal Center UTHealth McGovern Medical School Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Gelehrter","sequence":"additional","affiliation":[{"name":"C. S. Mott Children's Hospital University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Gembruch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine University Hospital Bonn Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3572-3877","authenticated-orcid":false,"given":"S.","family":"Grinenco","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Obstetrics and Division of Pediatric Cardiology Universidad Hospital Italiano de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0443-1997","authenticated-orcid":false,"given":"M.","family":"Haak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Division of Fetal Medicine Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Herberg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease University Hospital Aachen, RWTH Aachen Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9987-4223","authenticated-orcid":false,"given":"M. D.","family":"Kilby","sequence":"additional","affiliation":[{"name":"College of Health and Medical Sciences, University of Birmingham and Fetal Medicine Center, Birmingham Women's & Children's Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9527-3671","authenticated-orcid":false,"given":"S.","family":"Malekzadeh\u2010Milani","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence Malformations Cardiaques Cong\u00e9nitales Complexes\u2013M3C, H\u00f4pital Universitaire Necker\u2010Enfants Malades, Assistance Publique\u2013H\u00f4pitaux de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mellander","sequence":"additional","affiliation":[{"name":"Pediatric Heart Center Queen Silvia Children's Hospital, Sahlgrenska University Hospital Gothenburg Sweden"},{"name":"Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-0934","authenticated-orcid":false,"given":"S. A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics Texas Children's Hospital and Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ota\u00f1o","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Division of Obstetrics and Division of Pediatric Cardiology Universidad Hospital Italiano de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Pruetz","sequence":"additional","affiliation":[{"name":"Children's Hospital of Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Strainic","sequence":"additional","affiliation":[{"name":"The Heart Center, Nationwide Children's Hospital Columbus OH USA"},{"name":"The Congenital Heart Collaborative Rainbow Babies and Children's Hospital Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Texter","sequence":"additional","affiliation":[{"name":"The Heart Center, Nationwide Children's Hospital Columbus OH USA"},{"name":"The Congenital Heart Collaborative Rainbow Babies and Children's Hospital Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Tulzer","sequence":"additional","affiliation":[{"name":"Children's Heart Center Linz, Department of Pediatric Cardiology Kepler University Hospital Linz Austria"},{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Vigneswaran","sequence":"additional","affiliation":[{"name":"Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust Hospitals London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Wilkins\u2010Haug","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Brigham and Women's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the IFCIR Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.72.4.825"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90903-C"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-994166"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502840"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.04.025"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198203113061003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22138"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2023643"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23652"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26231"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24807"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.03.050"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.08.636"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.037"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2696"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27658"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000460247"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17530"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24792"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11531-5"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5238"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000475929"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009145"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18913"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.06.002"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.10.027"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11060170"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70245","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.70245","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T14:59:04Z","timestamp":1791125944000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.70245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/uog.70245"],"URL":"https:\/\/doi.org\/10.1002\/uog.70245","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"2025-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}