Detection of fetal congenital heart disease in a low-risk population

Hafner, E.; Scholler, J.; Schuchter, K.; Sterniste, W.; Philipp, K

doi:10.1002/(sici)1097-0223(199808)18:8<808::aid-pd359>3.0.co;2-k

Cited by 55 publications

(35 citation statements)

References 13 publications

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“…Elective termination rates are largely dependent upon prenatal diagnosis of CHD [25]. Notwithstanding improvements in prenatal detection of CHD since the 1980s, prenatal diagnosis of CHD remains challenging, e.g., infants with multiple defects are more likely to be diagnosed than infants with isolated CHD, and population-based estimates of prenatal diagnosis of CHD range from 31.7 to 57.0% [25][26][27]. Although NHBlack and Hispanic infants are less likely to have their CHD detected prenatally [28], there appears to be no differences in rates of elective terminations of CHD-affected pregnancies between NH-Blacks and NH-Whites [1].…”

Section: Discussionmentioning

confidence: 99%

Is the Prevalence of Specific Types of Congenital Heart Defects Different for Non-Hispanic White, Non-Hispanic Black and Hispanic Infants?

Nembhard

Salemi

Wang

et al. 2009

Matern Child Health J

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Background Our purpose was to determine the prevalence of specific types of CHD among non-Hispanic (NH)-Black, NH-White, and Hispanic infants. Methods We conducted a retrospective cohort study with 9,352 singleton infants diagnosed with conotruncal, right or left obstructive or septal CHDs from the Florida Birth Defects Registry, born 1998-2003 to resident NH-White, NH-Black, and Hispanic women aged 15-49. Defect-specific prevalence rates, prevalence ratios and P-values were calculated for each type of CHD and by number of defects for each racial/ ethnic group. Results Compared to NH-Whites, NH-Blacks had higher rates of pulmonary valve atresia/stenosis but lower frequency of aortic valve atresia/stenosis and ventricular septal defect. Hispanics had lower rates of aortic valve atresia/stenosis and atrioventricular septal defects than NH-Whites. Conclusions Although few racial/ethnic differences in prevalence are present among infants with major CHD, observed differences are clinically meaningful. However, the underlying etiologies for the observed differences remain unknown.

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Section: Discussionmentioning

confidence: 99%

Is the Prevalence of Specific Types of Congenital Heart Defects Different for Non-Hispanic White, Non-Hispanic Black and Hispanic Infants?

Nembhard

Salemi

Wang

et al. 2009

Matern Child Health J

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“…In many countries, ultrasound examination is used in the second trimester to look for congenital malformations as part of routine prenatal care. While tertiary centres have reported a high degree of accuracy in the detection of CHD, many studies have shown that cardiac abnormalities are commonly overlooked during routine obstetric evaluation and that there is a huge variation between centres in the same country, as well as differences between different countries (Bull, 1999;Garne et al, 2001;Buskens et al, 1996;Boyd et al, 1998;Hafner et al, 1998;Stumpflen et al, 1996;Jaeggi et al, 2001;Tegnander et al, 1995;Klein et al, 1999;Hafner et al, 1998;Stoll et al, 1998;Ott, 1995). This is important because, currently, high-risk pregnancies are referred for specialist fetal echocardiography, but the majority of babies with CHD are born to mothers with no identifiable high-risk factors.…”

Section: Introductionmentioning

confidence: 99%

Routine fetal cardiac screening: what are we doing and what should we do?

Sharland

2004

Prenatal Diagnosis

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In many countries, ultrasound examination is used in the second trimester to look for congenital malformations as part of routine prenatal care. While tertiary centres scanning high-risk pregnancies have reported a high degree of accuracy in the detection of congenital heart disease, many studies have shown that cardiac abnormalities are commonly overlooked during routine obstetric evaluation and there still remains a huge variation between centres. The majority of babies with congenital heart disease are born to mothers with no identifiable high-risk factors and so will not be detected unless there is widespread screening of the low-risk population. It is feasible to achieve widespread screening for fetal congenital heart disease in low-risk groups, but this does need commitment and effort from those performing the scans and those teaching them how to examine the heart. Staff performing routine obstetric ultrasound scans should learn a simple technique for examining the fetal heart and to use this in all patients. Links to a tertiary centre can provide support for checking scans of concern as well as for providing training and for obtaining feedback. In addition, an audit system needs to be established in each centre to trace false-positive and false-negative cases as well as to confirm true positives and true negatives.

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“…[1][2][3][4][5][6] In expert hands, the results may be extremely accurate. 7,8 Such a diagnosis tends to precipitate a crisis in the parents.…”

Section: Introductionmentioning

confidence: 99%