Results of Fetal Cardiac Ultrasonographic Screening in Our Institute

Abstract

Objective: Congenital heart disease (CHD) may take a serious turn in neonates. The present study aimed to investigate CHD cases diagnosed prenatally or postnatal at our institution and clarify the efficacy of fetal cardiac ultrasonographic screening.
Method: The study included singleton pregnant women who underwent fetal cardiac ultrasonographic screening at our hospital and gave birth between April 2008 and March 2012. A retrospective chart review was performed. Fetal cardiac ultrasonographic screening for low-risk pregnancy was performed 3 times at around 18, 28, and 36 weeksʼ gestation, via four-chamber, outflow tract, and three-vessel views. A specialized fetal echocardiography was performed for suspected cases by skilled obstetricians and pediatric cardiologists.
Result: A total of 9983 examinations were performed, and 15 cases of CHD were diagnosed in utero. Coarctation of the aorta (CoA); CoA and ventricular septal defect (VSD); double-outlet right ventricle; corrected transposition of the great arteries (cTGA); vascular ring; TGA; persistent left superior vena cava and VSD; dysplastic tricuspid valve; VSD and tricuspid atresia; mitral valve atresia, CoA, VSD, and pulmonary valve stenosis (PS); 2 as complete atrioventricular canal defect; and 3 as isolated VSD. Among the 15 cases, 6 were diagnosed by 4-chamber view and 8 by additional outflow tract view. There were 20 falsenegative cases. Tetralogy of Fallot; PS; VSD with bicuspid aortic valve; and 16 as isolated VSD. These 20 cases did not need critical care during the early neonatal period.
Conclusion: Our prenatal heart-screening program is clinically feasible to detect CHD. Reexamination in the third trimester may contribute to the diagnosis of CHD.