RESUMEN
The purpose of this study is to evaluate prospectively the accuracy of fetal echocardiography performed at a tertiary referral center [Aramco Dhahran Health Center] in defining the exact anatomic features of various cardiac lesions in fetuses with congenital heart disease. Fetal echocardiography has been used to plan the appropriate course of care for high-risk pregnancies and in the immediate neonatal period. This includes a team of obstetrician, radiologist, pediatric cardiologist, and neonatologist. A sample of 65 consecutive fetal echocardiograms and their matching neonatal echo/Doppler studies were compared. The referral sequence was initiated by the obstetrician to the radiologist, then to the pediatric cardiologist, and the neonatologist. Four groups of fetuses/neonates were identified in this study based on their fetal cardiac examination: [1] normal cardiac anatomy and performance [n = 30]: none had any significant cardiac lesion on postnatal echocardiogram; [2] fetal arrhythmia [n = 12]: premature atrial beats and bigeminy were found in 9 fetuses and disappeared in the immediate neonatal period. Atrial tachycardia [atrial rate 400's - ventricular rate 200's] was seen in 3 fetuses and required maternal and neonatal treatment with digoxin in one; [3] nonimmune hydrops fetalis was diagnosed in 8 fetuses: it was mild and resolved in 7 patients shortly after birth. One fetus died in utero with severe hydrops; and [4] complex congenital cardiac lesions were found in 11 fetuses [18%]. Some minor anatomic findings could not be defined prenatally in 7 of them. Four cases were excluded due to lack of correlation between pre- and postnatal studies. We conclude that [1] fetal echocardiography, as an intimate part of a comprehensive fetal assessment, is highly sensitive and specific in detecting congenital heart disease in the fetuses; [2] appropriate management of high-risk pregnancies and neonates can be significantly improved when the exact pathophysiology of the unborn fetus is known by fetal echo/Doppler; and [3] fetal echocardiography is extremely safe and reliable throughout the three trimesters