Factors influencing the prenatal detection of structural congenital heart diseases

Wong, S.F., Chan, F.Y., Cincotta, R.B., Lee-Tannock, A. and Ward, C. (2003) Factors influencing the prenatal detection of structural congenital heart diseases. Ultrasound In Obstetrics & Gynecology, 21 1: 19-25. doi:10.1002/uog.7


Author Wong, S.F.
Chan, F.Y.
Cincotta, R.B.
Lee-Tannock, A.
Ward, C.
Title Factors influencing the prenatal detection of structural congenital heart diseases
Journal name Ultrasound In Obstetrics & Gynecology   Check publisher's open access policy
ISSN 0960-7692
1469-0705
Publication date 2003-01-01
Sub-type Article (original research)
DOI 10.1002/uog.7
Volume 21
Issue 1
Start page 19
End page 25
Total pages 7
Editor S. Campbell
Place of publication Carnforth, England
Publisher Parthenon
Collection year 2003
Language eng
Subject C1
321014 Obstetrics and Gynaecology
730106 Cardiovascular system and diseases
Formatted abstract
Objective
To assess the factors influencing the prenatal detection rate of structural congenital heart diseases (CHDs).

Methods
A retrospective study was conducted at a major obstetric hospital in Australia between 1 January 1996 and 30 June 1999. The medical records of all fetuses and infants born with CHD, except those with isolated patent ductus arteriosus or secundum atrial septal defect, were reviewed. Only pregnancies that bad prenatal ultrasound scan assessments for morphological surveys were included. The following factors that may influence the detection rate were assessed: complexity of the lesions; experience of the sonographers (performance in tertiary versus non-tertiary institutions); presence of other structural or chromosomal anomalies; and maternal body mass index (BMI).

Results

The incidence of structural CHD in this series, excluding cases referred from other hospitals, was 7.0 per 1000 (179/25529). Of the 179 pregnancies with CHD, 151 bad prenatal ultrasound scans and were included in the study. The overall detection rate for CHDs in this series was 40.4%. The detection rate for isolated septal defects was poor (13.7%). The detection rates were significantly higher for complex lesions (54%), for lesions with concomitant septal defects (66.7%), and for lesions with abnormal four-chamber views (62.9%). The detection rate was also higher if the scan was performed in the tertiary institution, and if there were other chromosomal or structural anomalies. Maternal BMI did not affect the detection rate in the current series. Stepwise logistic regression analysis showed that three independent variables affecting the detection rate were complexity of the cardiac lesion, experience of the operator, and the detection of chromosomal anomalies.

Conclusion
A high detection rate for major CHDs can be achieved in a screening setting but there is still room for improvement in scanning skills in the four-chamber view and great-artery analysis in both tertiary and local centers. Copyright (C) 2002 ISUOG. Published by John Wiley Sons, Ltd.
Keyword Acoustics
Obstetrics & Gynecology
Radiology, Nuclear Medicine & Medical Imaging
Congenital Heart Disease
Detection Rate
Four-chamber View
Prenatal Diagnosis
Fetal Echocardiography
Human-fetus
4-chamber View
Diagnosis
Ultrasound
Pregnancy
Defects
Experience
Efficacy
Impact
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2004 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 02:33:00 EST