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Universal Fetal Echocardiography for Pregestational Diabetes Mellitus: A Cost-Effectiveness Analysis.
Obstet Gynecol
November 2024
Department of Obstetrics and Gynecology, University of Washington, and the Department of Maternal-Fetal Medicine, Providence Swedish Hospital, Seattle, Washington; and the Department of Maternal-Fetal Medicine, Kaiser San Diego, San Diego, California.
Objective: To evaluate the cost effectiveness of universal fetal echocardiogram for patients with pregestational diabetes mellitus by first-trimester hemoglobin A 1c (Hb A 1c ) level.
Methods: We developed a cost-effectiveness model comparing two strategies of screening for critical fetal congenital heart disease among patients with diabetes: universal fetal echocardiogram and fetal echocardiogram only after abnormal findings on detailed anatomy ultrasonogram. We excluded ventricular septal defect, atrial septal defects, and bicuspid aortic valve from the definition of critical fetal congenital heart disease.