Evaluation of a novel fetal echocardiography training programme in two tertiary care obstetric Centres

Improving and maintaining high detection rates for major congenital heart disease (CHD) is a priority for successful prenatal anatomy screening programmes. The primary objective of this study was to evaluate the utility of on-site multidimensional targeted training in fetal cardiac screening.

A prospective study evaluating a targeted fetal echocardiography (FE) training programme in two obstetric tertiary care units was established. The programme was designed and approved by a dedicated fetal cardiology team. The one-day intervention involved supervised hands-on sonography and a prescribed educational programme for sonographers and doctors. The programme was completed by 23 trainees. Evaluation of the programme involved pre and post-training questionnaires and retrospective evaluation of cardiac images from 10 randomly-selected anatomy screening examinations performed by each trainee before and after training. Images were assessed for both technical quality and 6 priority elements of cardiac screening taught in the programme. The results were described with summary statistics and non-parametric tests.

1850 fetal cardiac images obtained before and after training by 21/23 trainees were assessed. Significant improvement was seen in the priority cardiac views obtained, for example from 24%(5/21) to 86%(18/21) for bifurcating pulmonary artery (P-value 0.001), from 33%(7/21) to 86%(17/21) for differential atrio-ventricular valve insertion (P-value 0.001), In addition, technical image quality improvements were observed following training as well as sonographer confidence.

A targeted FE training programme can improve understanding of the priority elements required to exclude major CHD in prenatal screening, improve image quality, and sonographer confidence in cardiac screening.