Korean Circ J.  2012 Dec;42(12):839-844. 10.4070/kcj.2012.42.12.839.

Recent Trends in Indications of Fetal Echocardiography and Postnatal Outcomes in Fetuses Diagnosed as Congenital Heart Disease

• Cha S
• Kim GB
• Kwon BS
• Bae EJ
• Noh CI
• Lim HG
• Kim WH
• Lee JR
• Kim YJ
• Choi JY

• KMID: 1491100
• DOI: http://doi.org/10.4070/kcj.2012.42.12.839

Abstract

BACKGROUND AND OBJECTIVES
We hypothesized that fetal echocardiography (echoCG) is an accurate diagnostic tool reflecting well postnatal echoCG findings and outcomes.
SUBJECTS AND METHODS
We reviewed the medical records of 290 pregnant women, including 313 fetuses, who were examined by fetal echoCG at the Seoul National University Children's Hospital from January 2008 through April 2011.
RESULTS
The mean gestational age at diagnosis was 26.2+/-5.2 weeks. The mean age of mothers at diagnosis was 31.7+/-3.8 years. We identified indications for fetal echoCG in 279 cases. The most common indication was abnormal cardiac findings in obstetrical screening sonography (52.0%). Among the 313 echoCG results, 127 (40.6%) were normal, 13 (4.2%) were minor abnormalities, 35 (11.2%) were simple cardiac anomalies, 50 (16.0%) were moderate cardiac anomalies, 60 (19.2%) were complex cardiac anomalies, 16 (5.1%) were arrhythmias, and 12 (3.8%) were twin-to-twin transfusion syndrome. The most common congenital heart disease was tetralogy of Fallot (23 fetuses, 15.9%). One hundred forty-eight neonates were examined by echoCG. We analyzed differences between fetal echoCG and postnatal echoCG. In 131 (88.5%) cases, there was no difference; in 15 (10.1%), there were minor differences; and in only 2 (1.4%) cases, there were major differences.
CONCLUSION
There is a recent increase in abnormal cardiac findings of obstetric ultrasonography screenings that indicate fetal echoCG. Fetal echoCG is still a good, accurate diagnostic method for congenital heart disease.

Keyword

Prenatal diagnosis; Echocardiography; Ultrasonography, prenatal; Heart defect, congenital

MeSH Terms

Arrhythmias, Cardiac
Echocardiography
Female
Fetofetal Transfusion
Fetus
Gestational Age
Heart
Heart Defects, Congenital
Heart Diseases
Humans
Infant, Newborn
Mass Screening
Medical Records
Mothers
Pregnancy
Pregnant Women
Prenatal Diagnosis
Tetralogy of Fallot
Ultrasonography, Prenatal

Figure

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  Fig. 1 Postnatal outcomes of simple (A), moderate (B), and complex (C) cardiac anomalies on fetal echocardiography. Of 35 fetuses with simple cardiac anomalies, 20 were born at our hospital and 19 neonates survived after observation or operation. Forty-three of 50 fetuses with moderate cardiac anomalies were born at our hospital, 28 were survived after surgery in 30 patients. Thirty-nine of 60 fetuses with complex cardiac anomalies were born at our hospital, 23 were still alive after operation in 33 patients. Obs.: observation, DAB: died after birth, Tf.: transfer, Mx.: medication, Ix.: intervention, Op.: operation, Pre-Op D.: preoperative death, Surv.: survival, Exp.: expired, CHD: congenital heart disease, F/U: follow-up.

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