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Impact and issues of detecting fetal congenital heart defects in Kyushu, Japan
Yukako Yoshikane1, Toshiyuki Yoshizato, Yasuki Maeno
1Department of Pediatrics, School of Medicine, Fukuoka University, Fukuoka, Japan.
Insights
Prenatal screening for congenital heart defects (CHD) in Japan identified that most cases had obvious four-chamber view abnormalities or chromosomal anomalies. This prenatal detection aids in predicting fetal outcomes.
Area of Science:
- Cardiology
- Prenatal Diagnosis
- Medical Screening
Background:
- Congenital heart defects (CHD) are a significant concern in fetal development.
- Effective prenatal screening systems are crucial for early detection and management.
Purpose of the Study:
- To assess the current state of fetal CHD screening in Japan.
- To propose a framework for establishing a comprehensive CHD screening system in Japan.
Main Methods:
- Analysis of 168 fetuses with prenatal CHD diagnoses from 2003-2007 across four Japanese referral centers.
- Categorization into Group A (no extracardiac abnormalities/risk factors) and Group B (with abnormalities/risk factors).
- Comparative analysis of diagnostic findings and patient outcomes between the two groups.
Main Results:
- Group A showed higher incidences of single ventricle and restrictive ductus arteriosus compared to Group B.
- Abnormal four-chamber view was the primary referral reason in Group A; chromosomal anomalies were noted in 37 Group B cases.
- Group B exhibited higher mortality rates than Group A, with no significant difference in mortality for fetuses without chromosomal anomalies between the groups.
Conclusions:
- Prenatal diagnosis of CHD is often associated with evident four-chamber view abnormalities or chromosomal anomalies.
- Prenatal CHD detection is valuable for predicting fetal outcomes.
- Establishing a robust CHD screening system in Japan is warranted.
Aim:
To determine the current status of fetal CHD screening in our region and to establish a CHD screening system in Japan.
Material And Methods:
Subjects were 168 fetuses prenatally-diagnosed with CHD at four referral centers in Japan from 2003 to 2007. Subjects were divided into two groups: group A (n = 84) included cases without extracardiac sonographic abnormalities and known risk factors for CHD and group B (n = 84) included those with extracardiac sonographic abnormalities or risk factors. The diagnostics and outcomes between the groups were analyzed.
Results:
There were more cases of single ventricle and restrictive ductus arteriosus and fewer cases of ventricular septal defect and double outlet right ventricle in group A than in group B (P < 0.05). In group A, the most frequent referral reason was an abnormal four-chamber view. In group B, 37 cases had chromosomal anomalies. The mortality rates in group B were higher than those in group A (P < 0.05). There were no differences in mortality rates between fetuses without chromosomal anomalies in group B and group A.
Conclusion:
Prenatally-diagnosed CHD were mostly limited to those cases with obvious abnormalities in the four-chamber view or those with chromosomal anomalies. Prenatal detection of CHD is useful for the prediction of outcomes.
