Impact and issues of detecting fetal congenital heart defects in Kyushu, Japan.

Aim: To determine the current status of fetal CHD screening in our region and to establish a CHD screening system in Japan.

Material And Methods: Subjects were 168 fetuses prenatally-diagnosed with CHD at four referral centers in Japan from 2003 to 2007. Subjects were divided into two groups: group A (n = 84) included cases without extracardiac sonographic abnormalities and known risk factors for CHD and group B (n = 84) included those with extracardiac sonographic abnormalities or risk factors. The diagnostics and outcomes between the groups were analyzed.

Results: There were more cases of single ventricle and restrictive ductus arteriosus and fewer cases of ventricular septal defect and double outlet right ventricle in group A than in group B (P < 0.05). In group A, the most frequent referral reason was an abnormal four-chamber view. In group B, 37 cases had chromosomal anomalies. The mortality rates in group B were higher than those in group A (P < 0.05). There were no differences in mortality rates between fetuses without chromosomal anomalies in group B and group A.

Conclusion: Prenatally-diagnosed CHD were mostly limited to those cases with obvious abnormalities in the four-chamber view or those with chromosomal anomalies. Prenatal detection of CHD is useful for the prediction of outcomes.