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Approaching Universal Prenatal Detection of Significant Cardiovascular Malformations in Nevada
William N Evans1,2, Ruben J Acherman1,2, Katrinka T Kip1,3
1Children's Heart Center Nevada, Las Vegas, Nevada, USA.
Objective:
To report our recent experience with prenatal detection of significant cardiovascular malformations (CVMs) in Nevada's state-wide maternal population receiving prenatal care.
Methods:
We queried our databases for those with significant CVMs diagnosed pre- or postnatally between May 1, 2021, and April 30, 2024. We defined CVMs as those that required, would have required, or will likely require a therapeutic procedure in the first 12 months. Additionally, we included those with atrioventricular and ventriculoarterial discordance and left isomeric situs, both unaccompanied by additional CVMs, and congenital complete heart block. We defined routine prenatal care as obstetric care, which included at least one fetal anatomical survey ultrasound.
Results:
We identified 390 cases of significant CVMs. Of the 390 cases, 359 (92%) had prenatal care over the three-year observation period, with prenatal detection rates for the three 12-month intervals: 76% (87/115), 87% (94/108), and 95% (129/136) respectively (p < 0.001 by chi-square). A total of 310 prenatal diagnoses were made from comprehensive fetal echocardiograms performed on 8397 pregnant women at maternal-fetal-medicine centers.
Conclusion:
To our knowledge, these results represent the highest prenatal detection rate for significant CVMs, in a state-wide maternal population in the United States.
