Table 5.4.

Group IIA. Structural fetal heart diseases with possible in utero hemodynamic compromise and chance of fetal treatment, which require immediate neonatal care. Class of recommendation/level of evidence: IB.¹⁷,⁴¹,⁵⁷-⁵⁹

Heart disease	In utero outcome	In utero follow-up	Delivery	Postnatal assessment
PS PAIVS AS Ebsteins anomaly	Risk of ventricular hypoplasia Risk of ventricular dysfunction or fetal hydrops Risk of circular shunt Risk of fetal arrhythmia	Repeat the study every 2 to 4 weeks is recommended If signs of in utero progression, consider fetal intervention between 22 and 32 weeks If circular shunt, consider induced ductal constriction	Without hydrops, induced vaginal delivery or programmed C-section With hydrops, programmed C-section Level 2 or 3 center	Immediate neonatal cardiac assessment PAIVS requires neonatal treatment Severe or critical PS and AS, may require neonatal treatment Ebsteins anomaly needs treatment if pulmonary atresia and lung hypoplasia

AS: aortic stenosis; PAIVS: pulmonary atresia with intact interventricular septum; PS: pulmonary stenosis.