Fetal echocardiography for pregnant women expecting “Satogaeri” childbirth: an experience at a rural institute

Abstract

 Background: The unexpected detection of severe fetal heart defects（FHDs）can impart serious burden on Satogaeri pregnant women and their families. Satogaeri refers to pregnant women leaving their residence and returning to their parents’ residence for receiving perinatal care support.

 Objective: This study aims to report the results and issues regarding prenatal diagnosis of severe FHDs in Satogaeri pregnant women at a rural institute.

 Method: For over a period of 3 years, beginning in January 2017, 1,662 patients underwent fetal echocardiography at our institute under study. The prenatal diagnosis of FHDs and the outcomes in Satogaeri patients were retrospectively reviewed using electronic medical charts.

 Results: Of the 1, 662 patients, 346（21%）were Satogaeri. Additionally, the gestational age of Satogaeri patients was significantly higher than that of the non-Satogaeri patients（mean, 33.5 ± 2.6 weeks vs. mean, 27.2 ± 2.1 weeks, respectively; p < 0.01）. Nine Satogaeri patients had FHDs, of which three had fetal double outlet right ventricle, common arterial trunk, and pulmonary atresia with ventricular septal defect, and were hence referred to the tertiary institute.

 Conclusion: Severe FHDs after Satogaeri tend to be diagnosed during late gestation. Therefore, during the limited period until childbirth, changing the delivery institute may be necessary for the Satogaeri patients and their families without proper information about the fetal heart or sufficient psychological support available from practitioners. Thus, prior to Satogaeri, fetal echocardiography, including three-vessel trachea view for evaluating great vessel anomalies associated with many severe FHDs, is strongly recommended.