Fetal echocardiography in Manitoba: a regional perspective

In order to investigate the impact of detailed fetal echocardiography on perinatal care at a tertiary health care centre, the records of all 29 cases referred for fetal echocardiography during the years 1987-88 were reviewed. All patients had risk factors for offspring with congenital heart disease. A family history of congenital heart disease led to fetal echocardiography in about two-thirds of the cases, while the remainder were referred on the basis of abnormal cardiac screening examinations during fetal assessment. Forty examinations were performed on patients at gestational ages of 16 to 37 weeks. Detailed fetal echocardiography did not alter the perceived severity of major structural cardiac defects previously identified by an experienced fetal assessment unit and did not change or influence intrapartum care. The value of fetal echocardiography in the diagnosis and treatment of fetal tachyarrhythmias was confirmed. Also, fetal echocardiography provided reassurance of cardiac normality in cases with familial and maternal risk factors for congenital heart disease. Fetal echocardiography appears to be an inappropriate screening tool in view of its limited availability and focus. Comprehensive fetal assessment with four chamber cardiac imaging is the appropriate first-line screening test for patients with risk factors for offspring with congenital heart disease.