Role of routine fetal echocardiography in an unselected group of pregnant women for prenatal detection of cardiac malformations.
Congenital heart disease
Fetal echocardiography
Prenatal detection
Journal
Indian heart journal
ISSN: 2213-3763
Titre abrégé: Indian Heart J
Pays: India
ID NLM: 0374675
Informations de publication
Date de publication:
Historique:
received:
04
06
2020
revised:
13
07
2020
accepted:
04
08
2020
entrez:
15
11
2020
pubmed:
16
11
2020
medline:
12
5
2021
Statut:
ppublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 33189206
pii: S0019-4832(20)30209-1
doi: 10.1016/j.ihj.2020.08.010
pmc: PMC7670276
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
427-430Informations de copyright
Copyright © 2020 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.
Références
J Clin Diagn Res. 2017 Apr;11(4):TC12-TC14
pubmed: 28571229
BMC Med Imaging. 2020 Apr 3;20(1):33
pubmed: 32245426
Ultrasound Obstet Gynecol. 2001 May;17(5):386-91
pubmed: 11380961
Ultrasound Obstet Gynecol. 2010 Sep;36(3):279-84
pubmed: 20205153
Circulation. 2001 Mar 6;103(9):1269-73
pubmed: 11238272
Ultrasound Obstet Gynecol. 2014 Jul;44(1):50-7
pubmed: 24357432
J Ultrasound Med. 2007 Jan;26(1):1-3
pubmed: 17182702
J Ultrasound Med. 2020 Jan;39(1):E5-E16
pubmed: 31846540
Cardiol Young. 2019 Aug;29(8):1072-1077
pubmed: 31287035
J Am Coll Cardiol. 2015 Jul 28;66(4):388-99
pubmed: 26205597
Ultrasound Obstet Gynecol. 2006 Mar;27(3):252-65
pubmed: 16456842
Cardiovasc Diagn Ther. 2016 Feb;6(1):44-9
pubmed: 26885491
Echocardiography. 2015 Jun;32(6):1015-21
pubmed: 25231765
Cardiol Young. 2016 Feb;26(2):347-53
pubmed: 25912146
Acta Obstet Gynecol Scand. 2013 Jul;92(7):804-8
pubmed: 23521227
Prenat Diagn. 2002 Apr;22(4):285-95
pubmed: 11981909
Circulation. 2014 May 27;129(21):2183-242
pubmed: 24763516
Invest Radiol. 1972 May-Jun;7(3):152-8
pubmed: 5064272
Lancet. 1996 Sep 28;348(9031):854-7
pubmed: 8826811
Arch Argent Pediatr. 2020 Apr;118(2):e149-e161
pubmed: 32199055
Prenat Diagn. 2019 Nov;39(12):1148-1154
pubmed: 31499581
Indian Pediatr. 2018 Dec 15;55(12):1075-1082
pubmed: 30745481
Circulation. 1999 Feb 23;99(7):916-8
pubmed: 10027815
Int J Gynaecol Obstet. 2018 Feb;140(2):137-145
pubmed: 29094357
BJOG. 2015 Sep;122(10):1420-1
pubmed: 26307475
An Pediatr (Barc). 2015 Jan;82(1):27-34
pubmed: 24635979
J Am Coll Cardiol. 1996 Feb;27(2):481-6
pubmed: 8557925