Approaching Universal Prenatal Detection of Significant Cardiovascular Malformations in Nevada

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Pediatric Cardiology

Background:

• Significant cardiovascular malformations (CVMs) pose a substantial risk to newborns.
• Early prenatal detection of CVMs is crucial for timely intervention and improved neonatal outcomes.
• Nevada's statewide maternal population provides a unique setting to assess prenatal CVM detection rates.

Purpose of the Study:

• To evaluate the prenatal detection rates of significant cardiovascular malformations (CVMs) within Nevada's statewide maternal population.
• To assess the trend in CVM detection over a three-year period.
• To establish a benchmark for prenatal CVM detection in a large, diverse population.

Main Methods:

• A retrospective analysis of maternal databases from May 2021 to April 2024.
• Identification of CVM cases requiring therapeutic procedures within the first year of life.
• Inclusion of specific conditions like atrioventricular discordance and congenital heart block.
• Definition of routine prenatal care including fetal anatomical survey ultrasounds.

Main Results:

• A total of 390 significant CVM cases were identified.
• Prenatal detection rates increased from 76% to 95% over the three observation intervals (p < 0.001).
• 92% of CVM cases received prenatal care, with 310 diagnoses made via fetal echocardiograms in 8397 women.

Conclusions:

• The study reports the highest statewide prenatal detection rate for significant CVMs in the United States.
• The increasing detection rates highlight the effectiveness of enhanced prenatal screening protocols.
• These findings underscore the importance of comprehensive fetal echocardiography in maternal-fetal medicine centers.