Massive fetal cardiac rhabdomyoma treated with transplacental sirolimus
Bibliographic record
Abstract
Cardiac rhabdomyomas, the most common type of fetal cardiac tumor, can grow prenatally, in rare instances leading to heart failure and fetal demise.In severe cases, there have been reports of successful treatment with transplacental mechanistic target of rapamycin inhibitor (mTORi) therapy, specifically sirolimus.However, given the small number of published cases, the dosing regimen and safety profile of sirolimus in pregnancy for this indication remain undefined.This case details successful treatment with sirolimus therapy in a fetus with a massive septal cardiac rhabdomyoma leading to left ventricular cavity obliteration and left ventricular outflow tract (LVOT) obstruction with resulting fetal hydrops.A mother with a previous child with tuberous sclerosis complex presented for evaluation of rapidly enlarging fetal cardiac masses in the second trimester.Due to fetal hemodynamic compromise by 30 weeks gestational age (GA), the mother was initiated on oral sirolimus therapy.Two weeks after initiation of therapy, mass size and fetal hydrops had significantly improved.Oligohydramnios developed at 36 weeks GA, prompting delivery of a live-born infant appropriate for GA.Oligohydramnios has never been reported with maternal sirolimus use.With this case, we confirm previously described dosing regimens for treatment and describe the safety profile of sirolimus in pregnancy based on current national registry data.We also highlight the need for maternal and fetal monitoring after treatment initiation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".