Efficacy of fetal echocardiography in prenatal diagnosis of congenital heart diseases

Background. The discovery of ultrasound has made a revolution in almost all fields of medicine. The past three decades have withessed an intensive development of fetal echocardiography methods and technique. The aim of the paper is to present a review of the results and trends of the last 10 years of fetal echocardiography in Lithuania and to show the spectrum and outcomes of prenatally detected congenital heart diseases. Materials and methods. Fetal echocardiography was performed for 1816 fetuses during the period from 1999 to 2009. Results. Cardiac pathology was diagnosed in 176 (9.7%) fetuses. Heart defects were detected in 112 (63.6%) of them, cardiac rhythm and conduction disturbances in 62 (35.2%), cardiomyopathy in 2 (1.1%) fetuses, and heart rhabdomyoma in 1 (0.6%) fetus. The general rate of the postnatal diagnosis of congenital heart defects in Lithuania was about 10%. Most of fetal cardiac diseases (70.5%) were diagnosed after 22 weeks of gestation. Because most of antenatally diagnosed congenital heart defects (74%) were critical and inconsistent with life, a large part of newborns (40.2%) died in the neonatal period, 10.7% of fetuses died in utero, and 8% of pregnancies were terminated by abortion. The data demonstrate good tendencies: the diagnosis has become earlier, a wider spectrum of diseases have been diagnosed, more newborns have survived. Our survey shows that 41.1% of newborns with prenatally diagnosed congenital heart defects have survived. Conclusions. 10% of severe congenital heart diseases are detected prenatally in Lithuania. The efficacy of antenatal diagnostics depends on the qualification of specialists, the number of tertiary care centers, on a successful collaboration among pediatric cardiologists, obstetricians and geneticists. The main problem is an insufficient preparation of obstetricians, the uncertified favor of pediatric cardiologist. Keywords: congenital heart disease, fetal echocardiography, antenatal diagnostics

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Does prenatal diagnosis of critical congenital heart diseases influence the prereferral mortality in a center without surgical intervention?

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2018.1465551 ◽

2018 ◽

Vol 32 (20) ◽

pp. 3431-3434

Author(s):

Buse Özer Bekmez ◽

Evrim Alyamaç Dizdar ◽

Nilüfer Okur ◽

Mehmet Büyüktiryaki ◽

Nurdan Uraş ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Congenital Heart ◽

Surgical Intervention ◽

Heart Diseases ◽

Congenital Heart Diseases

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Letter in response to the article entitled “Prognosis of severe congenital heart diseases: Do we overestimate the impact of prenatal diagnosis?” by Vincenti et al.

Archives of Cardiovascular Diseases ◽

10.1016/j.acvd.2019.03.002 ◽

2019 ◽

Vol 112 (5) ◽

pp. 363-364

Author(s):

Pierre-Emmanuel Séguéla ◽

Julie Thomas ◽

Jean-Benoit Thambo

Keyword(s):

Prenatal Diagnosis ◽

Congenital Heart ◽

Heart Diseases ◽

Congenital Heart Diseases ◽

The Impact

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Prenatal diagnosis of congenital heart diseases in a tertiary hospital over two years

Medicina Clínica (English Edition) ◽

10.1016/j.medcle.2018.10.038 ◽

2020 ◽

Vol 154 (3) ◽

pp. 108-109

Author(s):

Lidia Cardiel Valiente ◽

Ariadna Ayerza Casas ◽

Pilar Samper Villagrasa

Keyword(s):

Prenatal Diagnosis ◽

Congenital Heart ◽

Heart Diseases ◽

Tertiary Hospital ◽

Congenital Heart Diseases

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Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0038-1676058 ◽

2018 ◽

Vol 41 (01) ◽

pp. 011-016 ◽

Cited By ~ 1

Author(s):

Diesa Pinheiro ◽

Bruna Varisco ◽

Marcelo Silva ◽

Rafaela Duarte ◽

Graciele Deliberali ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Fetal Heart ◽

Heart Diseases ◽

Fetal Echocardiography ◽

Congenital Heart Diseases ◽

Obstetric Ultrasound ◽

Morphological Evaluation

Abstract Objective To evaluate the accuracy of the diagnosis of fetal heart diseases obtained through ultrasound examinations performed during the prenatal period compared with the postnatal evaluation. Methods A retrospective cohort study with 96 pregnant women who were attended at the Echocardiography Service and whose deliveries occurred at the Complexo Hospitalar Santa Casa de Porto Alegre, in the state of Rio Grande do Sul, Brazil. Risk factor assessment plus sensitivity and specificity analysis were used, comparing the accuracy of the screening for congenital heart disease by means of obstetrical ultrasound and morphological evaluation and fetal echocardiography, considering p < 0.05 as significant. The present study was approved by the Research Ethics Committee of the Institution. Results The analysis of risk factors shows that 31.3% of the fetuses with congenital heart disease could be identified by anamnesis. The antepartum echocardiography demonstrated a sensitivity of 97.7%, a specificity of 88.9%, and accuracy of 93% in the diagnosis of congenital heart disease. A sensitivity of 29.3% was found for the obstetric ultrasound, of 54.3% for the morphological ultrasound, and of 97.7% for the fetal echocardiography. The fetal echocardiography detected fetal heart disease in 67.7% of the cases, the morphological ultrasound in 16.7%, and the obstetric ultrasound in 11.5% of the cases. Conclusion There is a high proportion of congenital heart disease in pregnancies with no risk factors for this outcome. Faced with the disappointing results of obstetric ultrasound for the detection of congenital heart diseases and the current unfeasibility of universal screening of congenital heart diseases through fetal echocardiography, the importance of the fetal morphological ultrasound and its performance by qualified professionals is reinforced for a more appropriate management of these pregnancies.

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