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[Prenatal cardiology. Suspicion to confirmation]
A J Macedo1, C Cruz, H Ribeiro
1Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Lisboa.
Acta Medica Portuguesa
|December 22, 1998
Summary
Prenatal diagnosis of fetal heart malformations significantly improved outcomes, decreasing mortality from 59% to 11%. However, many newborns with severe heart disease still lack prenatal diagnosis, highlighting the need for continued education.
Area of Science:
- Cardiology
- Prenatal Diagnosis
- Fetal Echocardiography
Context:
- High mortality and poor prognosis for newborns with prenatal heart malformations.
- Limitations in prenatal diagnosis, potentially due to reliance on the four-chamber view.
- Need to assess the range and evolution of cardiopathies diagnosed by fetal echocardiography.
Purpose:
- To retrospectively assess the range of cardiopathies diagnosed by fetal echocardiography and their evolution.
- To compare current findings with previous years' data.
- To evaluate the impact of improved diagnostic techniques and indications on outcomes.
Summary:
- 1173 fetal echocardiograms performed, identifying 61 (5.2%) fetuses with cardiac anomalies (56 structural, 5 arrhythmias).
- Indications for screening included maternal (37%), fetal (31%), familial (17%), and environmental (15%) factors.
- Mortality decreased from 59% to 11% compared to previous years, with increased diagnoses of heart disease.
- Despite improvements, many severe cases lacked prenatal diagnosis, emphasizing ongoing educational needs.
Impact:
- Significant reduction in mortality rates for newborns with diagnosed heart conditions.
- Increased detection rates for fetal cardiac anomalies.
- Highlights the critical need for enhanced prenatal screening and education for healthcare providers to improve newborn outcomes.