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Published on: May 5, 2018
Accuracy of prenatal diagnosis of congenital heart defects
V Berghella1, L Pagotto, M Kaufman
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Pennsylvania Hospital, Philadelphia, Pa, USA. vincenzo.berghella@mail.tju.edu
Insights
Prenatal echocardiography reliably detects congenital heart defects (CHD), achieving 95% sensitivity and 87% accuracy. Perinatal cardiologist involvement may enhance diagnostic accuracy for these fetal heart conditions.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Diagnostic Imaging
Background:
- Congenital heart defects (CHD) are a significant concern in prenatal care.
- Accurate prenatal diagnosis of CHD is crucial for appropriate management and outcomes.
Purpose of the Study:
- To assess the detection rate and accuracy of fetal echocardiography for diagnosing congenital heart defects (CHD).
- To compare the diagnostic performance of maternal-fetal medicine specialists and radiologists (MFM/R) with perinatal cardiologists (PC).
Main Methods:
- Retrospective review of fetal echocardiograms performed between January 1991 and June 1995.
- Comparison of prenatal CHD diagnoses with postnatal confirmations.
Main Results:
- Overall prenatal detection rate (sensitivity) for CHD was 95% with 87% accuracy.
- Perinatal cardiologists (PC) demonstrated higher diagnostic accuracy (92%) compared to MFM/R (74%) (p=0.02).
- Detection rates were similar between MFM/R (91%) and PC (97%) (p=0.4).
Conclusions:
- Prenatal echocardiography is a reliable method for identifying congenital heart defects.
- Involving perinatal cardiologists in prenatal diagnosis may improve the accuracy of CHD detection.
Objectives:
(1) To evaluate the detection and accuracy of fetal echocardiography for congenital heart defects (CHD). (2) To compare the detection and accuracy of a team of maternal fetal medicine specialists and radiologists (MFM/R) with those of perinatal cardiologists (PC).
Methods:
All fetal echocardiograms performed from 1/91 to 6/95 were reviewed retrospectively. CHD diagnoses made prenatally were compared with postnatally-confirmed diagnoses.
Results:
106 heat defects were correctly detected prenatally. There were 10 incorrect diagnoses, 6 false-negatives and 4 false-positives. Overall detection rate (sensitivity) was 95%, while overall accuracy was 87%. Detection rate for MFM/R and PC were 91 and 97%, respectively (p = 0.4). Accuracy was 74% for MFM/R and 92% for PC (p = 0.02).
Conclusions:
CHD can be identified reliably by prenatal echocardiography. The involvement of a PC in the prenatal diagnosis of these defects may improve diagnostic accuracy.
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