Prenatal diagnosis of congenital heart disease. Critical evaluation of a twelve-month experience.

• Type: Article in International Scientific Journal
• Date: 2000

Authors

Xavier, P (Author) Other; matias, a (Author) FMUP; Silva, JT (Author) Other; Montenegro N (Author) FMUP; Areias JC (Author) FMUP

Journal

Title: Revista Portuguesa de Cardiologia

Vol. 19 No. 3

Pages: 203-212

ISSN: 0870-2551

Publisher: Sociedade Portuguesa De Cardiologia

Indexing

Scopus - 1 Citation

Other information

Authenticus ID: P-008-PN7

Abstract (EN): INTRODUCTION: A retrospective study of fetal echocardiographies performed in the Ultrasound Unit of the Department of Obstetrics and Gynecology between January and December 1998 was carried out. MATERIAL AND METHODS: We performed 271 fetal echocardiographies (236 fetuses; 230 pregnant women). A triplex ultrasound machine was used with a 5 or 3.5 MHz transabdominal probe. RESULTS: The median maternal age was 31 years (17-44) and the median gestational age at the time of the first examination was 27 weeks (15-38). A hundred and thirty-two pregnant women (57.4%) were internal referrals and (98) 42.6% were referred by other hospitals. The most common indications for referral were maternal age > or = 35 years old (n = 48), gestational diabetes (n = 38), family history of congenital heart disease (n = 24) and insulin-dependent diabetes (n = 23). Accuracy of 32 echocardiographies was limited by technical difficulties. Out of 236 fetuses, 205 (86.9%) presented a normal scan, whereas 31 (13.1%) showed some abnormality: 22 structural cardiac defects; 5 rhythm anomalies and one with a mixed abnormality. In three cases a pericardial effusion was detected in the absence of any structural or rhythm anomaly and regressed spontaneously after birth. Three fetuses were referred prenatally for treatment to another center. Eight out of fifteen patients followed in the Pediatric Cardiology outpatient clinic were submitted to surgical treatment. In four cases the parents opted for termination of pregnancy and two neonatal deaths occurred. Four patients were lost for follow-up. DISCUSSION: Our study suggests that strict criteria for a referral of pregnant women to specialized fetal echocardiography are still missing. The median gestational age of 27 weeks at the time of the first examination was clearly out of the generally accepted recommended period (18-24 weeks). It is time to improve the collaboration between the different health professionals involved in the care of pregnant women in order to increase the sensitivity of screening for congenital heart disease.

Language: English

Type (Professor's evaluation): Scientific