24 iul. 2008 ACCURACY OF FETAL ECHOCARDIOGRAPHY IN THE HIGH RISK PREGNANCIES
Badreldeen Ahmed**, Amal El-Sisi*, Salwa Gendi*, Mohammed Numan*,
Najat Mohsen**, Najah Saleh, Zeena Al – Mansoori, Milan Stanojevic***
* Paediatric Cardiology Departmnet
**Obstetric and Gynaecology Department- Feto Maternal unit Hamad Medical Corporation, Doha, Qatar
***Department of Obstetrics and Gynecology, Medical School University of Zagreb, Sveti Duh Hospital
Objective: To determine diagnostic accuracy of fetal echocardiography in diagnosis of congenital heart defects (CHD) among high risk population referred to the unit of feto – maternal medicine (FMU).
Patients and Methods: A retrospective observational study was carried out over a period of three years from June 2002 to May 2005. All but two patients, who were lost to follow up, were delivered in the same hospital. The prenatally made diagnosis was compared with the postnatal echocardiographic and/or surgical findings. The population of women was 3256, 650 (19.9%) of whom fulfilled the inclusion criteria of the high risk population for fetal CHD, in which fetal echocardiography was performed after regular anomaly scan in the midgestation.
Results: In 650 pregnant women with singleton pregnancy fetal transabdominal echocardiography was performed at the mean gestational age of 22 ± 0,8 weeks (range 17 to 32 weeks). In 648 patients, postnatal diagnostic follow up was available. There were 91 (14%) cases diagnosed as having CHD, 9 of whom were false positive (1.4%), and one was false negative (0.15%). In the low risk population one neonate out of 2606 had CHD diagnosed in neonatal period, not detected during the regular prenatal screening check-up. Overall incidence of CHD was 84 out of 3256 (25,8 per 1000). The incidence of CHD in high risk population was 83 out of 650 (127,7 per 1000), and in low risk population it was 1 out of 2606 (0,38 per 1000).
Conclusion: Fetal echocardiography screening allows accurate diagnosis of congenital heart defects in the FMU. It should be performed in every pregnant woman, not only in the high risk pregnancies, because some of the CHD could be missed in the low risk population. This approach can have positive influence on the management of these patients and their families.