Objectives: We sought to describe the implementation and effectiveness of a statewide fetal tele-echocardiography program serving a resource-limited population.
Study Design: In 2009, our heart center established six satellite clinics for fetal tele-echocardiography around the state. We retrospectively reviewed all fetal tele-echocardiograms performed through 2018. Yearly statewide prenatal detection rates of operable congenital heart disease were queried from the Society of Thoracic Surgeons database.
Result: In 1164 fetuses, fetal tele-echocardiography identified all types of congenital heart disease, with a sensitivity of 74% and specificity of 97%. For the detection of ductal-dependent congenital heart disease, fetal tele-echocardiography was 100% sensitive and specific. Between 2009 and 2018, annual statewide prenatal detection rates of congenital heart disease requiring heart surgery in the first 6 months of life rose by 159% (17-44%; R = 0.88, p < 0.01).
Conclusions: The present study provides a framework for an effective, large-scale fetal tele-echocardiography program.
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http://dx.doi.org/10.1038/s41372-020-0677-2 | DOI Listing |
Diagnostics (Basel)
November 2024
Feto Maternal Centre, Al Markhiya Doha, Doha P.O. Box 34181, Qatar.
: Antenatal diagnosis of cardiac abnormalities and counselling parents about postnatal care require a multidisciplinary team, which includes a paediatric cardiologist, a neonatologist, and a fetal medicine physician. Some of these kinds of expertise are not available in all centres with fetal medicine expertise. However, with modern technology, this could be provided remotely.
View Article and Find Full Text PDFPrenat Diagn
August 2022
Department of Pediatrics, Division of Pediatric Cardiology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Background: To improve the rate of prenatal diagnosis of Congenital heart disease (CHD) in Kentucky, four fetal tele-echocardiography sites were established at regional hospitals in Kentucky: Ashland in 2011, Paducah in 2014, Lexington in 2014, and Owensboro in 2016.
Methods: A 13-year retrospective review of medical records at Norton Children's Hospital was performed to identify patients with CHD who had cardiac surgery or intervention prior to one year of age. The rate of prenatal diagnosis prior to establishing any fetal tele-echocardiography sites was compared to the rate of prenatal diagnosis after the sites were established.
Prog Pediatr Cardiol
September 2020
Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, United States of America.
The World Health Organization declared the novel coronavirus, or COVID-19, a pandemic in March 2020. Given the severity of COVID-19, appropriate use criteria have been implemented for fetal echocardiography. Screening low risk pregnancies for critical congenital heart disease has typically been a shared responsibility by pediatric cardiologists, obstetricians, and maternal fetal medicine (MFM).
View Article and Find Full Text PDFJ Perinatol
October 2020
Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR, 72202, USA.
Objectives: We sought to describe the implementation and effectiveness of a statewide fetal tele-echocardiography program serving a resource-limited population.
Study Design: In 2009, our heart center established six satellite clinics for fetal tele-echocardiography around the state. We retrospectively reviewed all fetal tele-echocardiograms performed through 2018.
Telemed J E Health
June 2017
Division of Pediatric Cardiology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky.
Background: Prenatal diagnosis of complex congenital heart disease (CHD) has been shown to improve newborn outcomes. The rate of prenatal diagnosis and access to fetal echocardiography vary widely across the United States.
Introduction: A clinical fetal tele-echo service was established at King's Daughters Medical Center (KDMC) in Ashland, KY, a region in eastern Kentucky that is 3 h from the nearest congenital heart surgeon.
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