Concordance of fetal echocardiography in the diagnosis of congenital cardiac disease utilizing updated guidelines

Abstract

Objective: We sought to examine the concordance of prenatally diagnosed congenital cardiac disease with postnatal echocardiography.

Study design: Patients who underwent fetal echocardiograms performed by pediatric cardiologists at a single referral center from January to December 2014 were reviewed. Fetal echocardiography exams were performed in accordance with guidelines by the American Institute of Ultrasound in Medicine (AIUM) and the American Heart Association (AHA) guidelines (2013 and 2014, respectively). The concordance of prenatal diagnosis was compared to postnatal echocardiograms.

Result: One hundred and six patients were included. Overall, the prenatal diagnosis precisely matched the postnatal diagnosis in 69.8%, minor discrepancies were seen in 14.2% and major differences were seen in 16% of cases. Three cases with major differences resulted in a more guarded postnatal prognosis; all three were fetuses with complex disease where the additional finding of total anomalous pulmonary venous return (TAPVR) was missed.

Conclusion: Fetal echocardiograms performed in our specialized fetal cardiology program are in high agreement with postnatal diagnosis of congenital cardiac disease. A worse postnatal prognosis is uncommon. Emphasis on pulmonary venous imaging in complex congenital heart disease is vital.

Keywords:

• Fetal echocardiography
• heart defects
• fetal heart/diagnostic imaging
• ultrasonography
• prenatal diagnosis
• pregnancy

Acknowledgements

We would like to acknowledge Jeanine Walk, RDMS and Paula Wickham, RDMS for their work on collecting data for this project. We would also like to thank Abbey Sidebottom, PhD and Marc Vacquier for their assistance with article preparation.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.