[Prenatal detection and management of congenital heart disease]

Antenatal diagnosis of congenital heart diseases rests on a two steps procedure. 1) A first intended fetal echocardiography which takes place during the two first trimesters of gestation, either early oriented by the familial or maternal history or the finding of fetal developmental abnormalities (intra uterine growth retardation, defects), or systematically performed as part of the fetal echography of the second trimester. 2) A second echocardiography which is part of a specialized cardiologic evaluation; its aims are to define the cardiac phenotype, to specify the hemodynamic tolerance of the heart defect, to orientate the genetic diagnosis, and finally to evaluate the cardiac prognosis.