Estimation Method for the Severity of Postnatal Congenital Heart Disease from Assessments Made during the Fetal Period

Abstract

In recent years, there have been an increasing number of fetuses diagnosed by fetal echocardiography as having congenital heart disease (CHD). Fetal echocardiography in Japan is divided into 2 levels: Level 1–fetal heart screening and Level 2–detailed fetal heart examinations. Pediatric cardiologists are mainly responsible for Level 2 fetal echocardiography. As a result of improved diagnosis of Level 2 fetal echocardiography, both the diagnosis and “assessment of the severity of the disease” are now required. There are two categories of severity: 1) Severity classification by CHD type and 2) Severity determination in each case of the disease. For category 1, assessment can be made by reference to the CHD classification scale developed by Allan LD (in which the severity of fetal CHD is measured on a scale of 1 to 10) and/or to the fetal heart triage chart by Shiono et al. For category 2, it is necessary to recognize and measure the points for evaluating the differences in severity within each disease group. It is important for fetal cardiologists to understand such severity assessments, and it is now essential to become a certified Level 2 fetal echocardiologist.