Effectiveness of fetal ultrasound diagnostics in cardiac malformations and association with polyhydramnios and oligohydramnios

Abstract

Background: Examine the effectiveness of prenatal ultrasound diagnostics in the detection of cardiovascular malformations, and their association with polyhydramnios and oligohydramnios.Methods: We examined the fetal ultrasonography and postnatal clinical/fetopathological data of 372 newborns/fetuses over a 7-year period in a tertiary centre. Fetal echocardiography was performed in cases of suspected US findings between 18-32 weeks. During the ultrasound the amniotic fluid amount was measured and the amniotic fluid index (AFI) or largest amniotic fluid pocket was determined.Results: Prenatal ultrasonographic results and postnatal/fetopathological diagnosis were fully congruent in 236/372 cases (63.4%), and in 66/372 cases of cardiovascular anomalies (17.7%) the discovery was partial, while in 70/372 cases no fetal cardiovascular anomalies were diagnosed during pregnancy (18.8%) (false negative). Cardiovascular malformations were isolated in 255 cases, in 172 of which (67.5%) the results of prenatal ultrasonography and postnatal diagnostics were fully congruent. In 43 cases (16.9%) the prenatal discovery was partial, and in 40 cases (15.7%) there was no prenatal recognition of the malformation.Cardiovascular abnormalities were found as a part of multiple malformations in 76 cases. In 41 fetuses the cardiovascular malformation was associated with chromosomal abnormalities. Cardiovascular malformations were significantly associated with polyhydramnios. Although in some of the cardiovascular malformations the association rate with polyhydramnios was high (AVSD, double outlet right ventricle, tetralogy of Fallot), we found a moderate association rate (19.7%). The association with oligohydramnios was 8.57%. Conclusions:Echocardiography plays an important role in the prenatal diagnostics. In cases of polyhydramnios and oligohydramnios, fetal echocardiography should be performed.

A study on referral pattern for fetal echocardiography and identifying the various risk factors for congenital heart defects

“…A study from Hungry found a significant association between CHD and Polyhydramnios. 19 The maximum proportion of CHD, i.e., 50%, was found in the women having an indication of cardiac anomaly on ultrasonography screening, and the correlation between cardiac anomaly on USG and the CHD detection was statistically significant (p value < 0.001). Our findings were similar to those of Nair et al, 8 with a CHD detection rate of 58%, Regmi et al, 9 with a CHD detection rate of 50%, and Li et al, 20 with a CHD detection rate of 64%.…”

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“…A study from Hungry found a significant association between CHD and Polyhydramnios. 19 The maximum proportion of CHD, i.e., 50%, was found in the women having an indication of cardiac anomaly on ultrasonography screening, and the correlation between cardiac anomaly on USG and the CHD detection was statistically significant (p value < 0.001). Our findings were similar to those of Nair et al, 8 with a CHD detection rate of 58%, Regmi et al, 9 with a CHD detection rate of 50%, and Li et al, 20 with a CHD detection rate of 64%.…”

Congenital heart disease in a patient with COVID-19 infection during early pregnancy: a case report

“…Because polyhydramnios is highly correlated with fetal AVSD, echocardiograms should be performed when polyhydramnios is detected by ultrasound in any mother who has CHD risk factors, such as viral infection [ 15 ].…”