Cyanotic Congenital Heart Disease Modes of Presentation and Prenatal Detection

Area of Science:

• Cardiology
• Prenatal Diagnosis
• Public Health

Background:

• Prenatal detection of structural congenital heart disease (CHD) is crucial for optimizing patient outcomes.
• Disparities exist in prenatal CHD detection rates based on screening protocols.

Purpose of the Study:

• To compare prenatal detection rates of critical CHD between centers offering universal fetal anomaly scans and those offering selective screening.
• To evaluate the impact of prenatal diagnosis on clinical outcomes, including intensive care admission and survival.

Main Methods:

• Retrospective analysis of 113 infants with critical CHD.
• Comparison of detection rates and clinical outcomes between universal and selective screening groups.

Main Results:

• Overall prenatal detection rate for critical CHD was 57%.
• Universal screening centers achieved a 71% detection rate versus 29% in selective screening centers.
• Postnatal diagnosis was linked to increased PICU admission, mechanical ventilation, and a tenfold higher one-year mortality rate.

Conclusions:

• Universal fetal anomaly screening significantly enhances prenatal detection of critical CHD.
• Prenatal diagnosis improves pre-operative stability and one-year survival for infants with CHD.
• Equitable access to universal screening is essential to mitigate risks associated with delayed diagnosis.