Efficacy of fetal echocardiography in prenatal diagnosis of congenital heart diseases
Keywords:CHDs, ISUOG, ANC, echocardiogram
Background: Congenital heart diseases are the commonest fetal congenital defects and until nowadays most of them are bypassed without prenatal diagnosis to be still considered as unexplained stillbirths or perinatal deaths. In this study, we tried to prove the importance of routine fetal cardiac screening in the ANC visits and also confirming its high accuracy.
Methods: This study was prospective longitudinal one, including doing ISUOG extended fetal cardiac screening for one hundred foetuses scheduled at certain gestational age visits, whom their half were at risks for CHDs and the other were not, with comparing the results to antenatal and postnatal detailed fetal echocardiography.
Results: The best gestational age for the fetal cardiac screening was at 18-22 weeks gestation. The accuracy of the screening to the antenatal echocardiogram was 96%-100% and to the postnatal one was 96%-98%.
Conclusions: CHDs are still the commonest congenital fetal defects and the antenatal fetal cardiac screening by extended basic views has high accuracy. Making this screening a routine in ANC visits will be of great help in improving the fetal outcome.
Khoshnood B, Lelong N, Houyel L. Prevalence, timing of diagnosis and mortality of newborns with congenital heart defects: a population based study. 2012;98(22):1667-73.
Yu Z, Xi Y, Ding W, Han S, Cao L, Zhu C, et al. Congenital heart disease in a Chinese hospital: pre and postnatal detection, incidence, clinical characteristics and outcomes. Pediatrics International. 2011;53(6)1059-65.
Ozbarlas N, Erdem S, K¨uc O, ¨ukosmano˘. Prevalence and distribution of structural heart diseases in high and low risk pregnancies. Anadolu Kardiyol Derg. 2011;11:125-30.
Galindo, Herraiz I, Escribano D, Lora D, Melchor JC, de la Cruz J. Prenatal detection of congenital heart defects: a survey on clinical practice in Spain. Fetal Diagnosis and Therapy. 2011;29(4):287-95.
Nelle M, Raio L, Pavlovic M. Prenatal diagnosis and treatment planning of congenital heart defects-possibilities and limits. World J Pediatr. 2009;5(1):18-22.
Mahle WT, Newburger JW, Matherne GP. Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the AHA and AAP. Pediatrics. 2009;124(2):823-36.
Jenkins KJ, Correa A, Feinstein JA. Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American heart association council on cardiovascular disease in the young: endorsed by the American academy of pediatrics. Circulation. 2007;115(23):2995-3014.
Srinivasan S. Fetal echocardiography. Ind J Pediatr. 2000;67:S20-S5.
Comstock CH. What to expect from routine midtrimester screening for congenital heart disease. Semin Perinatol. 2000;24:331-42.
Friedman AH, Kleinman CS, Copel JA. Diagnosis of cardiac defects: where we’ve been and where we’re going. Prenat Diagn. 2002;22:280-4.
Kleinman CS, Hobbins JC, Jaffee CC, Lynch DC, Talner NS. Echocardiographic studies of the human fetus: prenatal diagnosis of congenital heart disease and cardiac dysrhythmias. Pediatrics. 1980;65:1059-67.
Hsieh CC, Kuo DM, Chiu TH, Hsieh TT. Prenatal diagnosis of major congenital cardiovascular malformations. Gynecol Obstet Invest. 1996;42:84-7.
Cooper MJ, Enderlein Ma, Dyson DC, Roge CL, Tarnoff H. Fetal echocardiography: retrospective review of clinical experience and anevaluation of indications. Obstet Gynecol. 1995;86:577-82.
International society of ultrasound in obstetrics and gynecology, cardiac screening examination of the fetus: guidelines for performing the basic and extended basic cardiac scan, Ultrasound in Obstetrics and Gynecology. 2006;27:107-13.
Volpe P, Tuo G, De Robertis V, Campobasso G, Marasini M. Fetal interrupted aortic arch: 2D-4D echocardiography, associations and outcome. Ultrasound Obstet Gynecol. 2010;35:302-9.
Yifie Li, Hua Y, Fang J, Wang C, Qiao L. Performance of different scan protocols of fetal echocardiography in the diagnosis of fetal congenital heart disease: a systematic review and meta-analysis. PLoS ONE. 2013;8(6):e65484.
Luciane A, Edward A, Liliam C, Fernanda S. Prenatal detection of congenital heart diseases: one-year survey performing a screening protocol in a single reference center in Brazil; cardiology research and practice volume. 2014;175635:5 pages.
Clur SAB, Van Brussel PM, Mathijssen IB, Pajkrt E, Ottenkamp J, Bilardo CM. Audit of 10 years of referrals forfetal echocardiography. Prenatal Diagnosis. 2011;31(12):1134-40.
Emam SM. High prevalence of complex congenital cardiac anomalies detected by fetal echocardiography in a cohort of Saudi women referred for prenatal assessment. Journal of the Egyptian Society of Parasitology. 2012;42(2):281-90.
Ozkutlu S, Akca T, Kafal G, Beksac S. The results of fetal echocardiography in a tertiary center and comparison of lowand high-risk pregnancies for fetal congenital heart defects. Anadolu Kardiyol Derg. 2010;10:263-9.
D’Amelio R, Giorlandino C, Masala L. Fetal echocardiography using transvaginal and transabdominal probes during the first period of pregnancy: a comparative study. Prenat Diagn. 1991;11:69-75.
Dolkart LA, Reimers FT. Transvaginal fetal echocardiography in early pregnancy: normative data. Am J Obstet Gynecol. 1992;165:688-91.
Sharland GK, Allan LD. Screening for congenital heart disease prenatally. Results of a 2 1/2-year study in the South East Thames Region. Br J Obstet Gynaecol. 1992;99:220-5.
Randall P, Breal S, Hahn S, Khan k, Parsons JM. Accuracy of fetal echocardiography in the routine detection of congenital heart disease among unselected and low risk populations: a systematic review. BJOG. 2005;122(1):24-30.
Berkley EM, Goens MB, Karr S, Rappaport V. Utility of fetal echocardiography in postnatal management of infants with prenatally diagnosed congenital heart disease. Prenat Diagn. 2009;29:654-8.