AI Article Synopsis

  • The study explored improving the detection of congenital heart disease (CHD) during pregnancy by offering detailed fetal echocardiography (FE) to all women.
  • Out of 1445 pregnant women examined, the prevalence of CHD was found to be 8.3 per 1000, with many cases occurring in women without known risk factors.
  • The findings showed that FE is highly effective, with a sensitivity of 91.7% and a specificity of 100%, suggesting it should be routinely performed in all pregnancies to catch CHD cases.

Article Abstract

Objectives: We investigated the potential for improvement in prenatal detection of congenital heart disease (CHD) by routinely performing detailed fetal echocardiography (FE) in all pregnant women.

Methods: Following routine obstetric sonography, 1445 unselected pregnant women were prospectively subjected to FE at gestational ages between 16 and 24 weeks, or at first visit, if they presented later. Maternal or fetal factors, conventionally known to be associated with risk of CHD, were noted. The prevalence and detection rates of cardiac abnormalities were determined, and confirmation of findings by postnatal follow-up was done to ensure accuracy of FE. Prevalence of CHD was compared in pregnancies with or without conventional risk factors.

Results: The overall prevalence of CHD was 8.3 per 1000; only 2 CHD cases belonged to the high maternal risk group, while 10 cases were observed without maternal risk factors. Cardiac malformations were suspected in 14 fetuses during obstetric scan; but, only 5 of them had CHD, remaining 9 had structurally normal hearts. 50% of CHD cases occurred in pregnancies not associate with any (fetal or maternal) risk factor. The sensitivity, and specificity for prenatal CHD detection were 91.7% and 100% respectively.

Conclusions: Our study indicates that a substantial proportion of CHD cases occur in women not having high risk of giving birth to children with CHD. FE is a highly sensitive and specific test with strong predictive values. We recommend that FE should be done in every pregnancy.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670276PMC
http://dx.doi.org/10.1016/j.ihj.2020.08.010DOI Listing

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