ABSTRACT
A prospective observational study at the newly established Fetal Medicine Unit Hamad Hospital, Qatar, evaluated the impact of the service on the detection rate of critical congenital heart defects, patterns of referral and subsequent yield for structural congenital heart disease in a population with a significant proportion of high risk factors. Of 391 pregnant females examined between January 2003 and December 2004, 58 [14.8 percent] had fetal cardiac abnormalities of which 23 [5.8 percent of total referrals] had major structural malformations of the heart. Cases of fetal congenital heart disease had further evaluation using real time three-dimensional echocardiography [RT3DE] which is new equipment in the paediatric cardiology department. All cases with cardiac defects whether minor or major had follow up fetal echocardiography. Neonatal echocardiography confirmed the diagnosis in all cases with major defects [100 percent specificity]. False positive cases that were found to be normal post natal were 1 percent of the total cases referred [12 percent of cases with congenital malformation]. False negative cases were 1 percent and all had a small ventricular septal defect [VSD] except for one Down's syndrome with a very large VSD. Three patients needed urgent Caesarean section [CS] deliveries, one with complete heart block [HB] and two with supraventricular tachycardia [SVT]. One patient traveled abroad as the fetus had left isomerism and major cardiac defects and complete HB. Fifteen newborns had to receive prostaglandin based on the fetal diagnosis before being seen by paediatric cardiologists. There was no termination of pregnancy due to major cardiac defects even in cases of HLHS. The preliminary results of this clinic are very satisfactory and have affected favorably the outcome of the new-borns with congenital heart defects. It is hoped that the results of this study will encourage more referrals to the FMU