Audit of 10 years of referrals for fetal echocardiography

Area of Science:

• Cardiology
• Prenatal Diagnosis
• Medical Imaging

Background:

• Tertiary level fetal echocardiography is crucial for diagnosing cardiac conditions.
• Referral trends and outcomes provide insights into prenatal cardiac care effectiveness.
• Understanding indications and diagnoses aids in optimizing referral pathways.

Purpose of the Study:

• To analyze trends, indications, diagnoses, associated defects, and outcomes in fetuses undergoing echocardiography.
• To evaluate the impact of national screening programs on referral patterns.
• To assess the correlation between fetal findings and pregnancy outcomes.

Main Methods:

• Retrospective analysis of fetal echocardiograms from April 1999 to 2009.
• Inclusion of 623 fetuses with detailed data on cardiac and noncardiac anomalies.
• Review of referral indications, including increased nuchal translucency (NT).

Main Results:

• 48% of fetuses had cardiac pathology, with 81% of those having congenital heart defects (CHDs).
• Mortality rate for chromosomally normal fetuses with CHDs was 43%.
• Termination of pregnancy (TOP) rates varied, with higher rates for early diagnoses and presence of noncardiac anomalies. Increased NT was a significant predictor of CHDs.

Conclusions:

• Referral criteria for fetal echocardiography are appropriate, identifying significant cardiac pathology in nearly 50% of cases.
• High mortality and termination rates underscore the severity of diagnosed fetal heart conditions.
• Increased NT is a strong predictor of CHDs, guiding timely intervention and management decisions.