The Impact of Fetal Echocardiography on the Treatment and Outcome of Congenital Heart Disease: Report of Fetal Diagnosis of Congenital Heart Disease in 2001 at CHA Hospital

ABSTRACT

PURPOSE: Prenatal diagnosis of congenital heart disease has been made by fetal echocardiography and its clinical impact on the outcome of CHD cases has been analysed. METHODS: A prospective study was performed for the fetal diagnosis of CHD for the standard risk pregnancy, confirmed postnatally or at second study and/or at autopsy and/or follow up at CHA hospital in 2001. Incidence of CHD has been calculated and compared to the incidence of CHD of the prescreening period(1992.3-1995.2). RESULTS: There were 66 cases of CHD prenatally during the study period. CHD consisted of 7 cases of ventricular septal defects(VSD), 7 cases of tetralogy of Fallot(TOF), 5 cases of heterotaxy, 5 cases of double outlet right ventricle(DORV), 5 cases of severe pulmonary stenosis(PS), 3 cases of hypoplastic left heart syndrome(HLHS), 3 cases of coarctation, 3 cases of critical aortic stenosis(AS), 3 cases of pulmonary atresia with intact ventricular septum(PA IVS). Among 66 fetal CHD cases, 30 cases of CHD has been terminated, 1 case died in utero and 23 cases has been delivered at cardiac center through planned delivery. The most common factors of termination were extracardiac and chromosomal anomaly. 17 cases of false negative diagnosis were small VSD and mild PS that couldn't be diagnosed in fetal stage. There was no false positive diagnosis. There were 30 cases of CHDs born in 2001 at CHA hospital. 28 cases were diagnosed postnatally. Among 30 cases of CHDs, there were 18 cases of VSD(17 small VSD), 6 cases of mild PS, 4 ASD, 1 PDA. Incidence rate of CHD in 2001 and period 1992.3-1995.2 were 5.95 and 10.15/1,000 livebirth respectively. CONCLUSION: The data suggested that all of the significant CHDs could be diagnosed prenatally accurately by fetal echocardiography. And the incidence rate of CHD has been decreased by 41.4%. And the most of the complex CHD has been transferred to the cardiac center for planned delivery or has been terminated. The rate of termination was 45.5%.