Prenatal diagnosis of fetal conotruncal anomalies by echocardiography / 中华围产医学杂志

ABSTRACT

Objective To evaluate the accuracy of prenatal diagnosis of fetal conotruncal anomalies with echocardiography. Methods Fetal echocardiography were conducted for all women in their antenatal visits from Jan 2003 to Dec 2004. The echocardiographic diagnosis was compared with cardiac pathology results. Results Among 2063 women who had fetal echocardiographiy performed, conotruncal anomaly was detected in 28 fetuses with the average gestation of 26. 6 (16-40) weeks when the diagnosis was made, including tetralogy of Fallot (n=5), double outlet right ventricle (n = 6) , transposition of the great arteries (n = 5) , truncus arteriosus (n = 9) and ventricular septal defect with suspected overriding aorta (n=1). Four of the 28 fetuses were lost during follow up and the accurate rate of prenatal assessment of the great artery relationship was 75. 0% (18/24). Two fetuses with prenatal diagnosis of truncus arteriosus were reported as having pulmonary atresia with ventricular septal defect at autopsy. An overriding aorta was suspected in the other case, but postnatal echocardiography was diagnosed as perimembranous subaortic defect. Two fetuses with prenatally suspected double outlet right ventricle were diagnosed as having transposition of the great arteries at autopsy. Only one false-negative diagnosis was made in this series (4. 2%). Conclusions Conotruncal anomalies can be correctly diagnosed by fetal echocardiography. A combination of different views is necessary to define the exact spatial relationship of the great arteries. Specific diagnosis remains a challenge in some cases.