Implications and limitations of an abnormal fetal echocardiogram

Diagnosis and prognosis of fetuses with double outlet right ventricle

“…Copyright With respect to the relationship of the great vessels to one another and the position of the VSD, the accuracy of prenatal diagnosis of DORV was 100% in this study. This data is superior to previous reports in the literature that describe the reliability of prenatal diagnosis of conotruncal anomalies between 77 and 82% accurate (Allan et al, 1994;Tometzki et al, 1999) and of unselected cardiac anomalies about 90% (Davis et al, 1990;Forbus et al, 2004). Limitations in previous studies included delineation of the relationship of the great arteries (Tometzki et al, 1999).…”

Accuracy of fetal echocardiography: a cardiac segment‐specific analysis

“…Prior reports have established the ability of fetal 2D and Doppler echo to distinguish normal from abnormal fetal hearts4, 10, 11. There is further evidence establishing the accuracy of fetal echo for identifying specific congenital heart malformations1–3, such as functional single ventricle6 and conotruncal anomalies7, particularly when there is an experienced pediatric cardiologist5 involved in the study. However, we are unaware of any prior data analysis of the segment‐specific accuracy of fetal echo, particularly when held to the higher standards usually reserved for TTE.…”

“…The general diagnostic accuracy of fetal echocardiography (fetal echo) in detecting or excluding significant fetal heart anomalies has been reported to exceed 80%1–4, particularly in the hands of experienced perinatal cardiologists2, 5. Fetal echo has been shown to be particularly accurate in the detection of complex congenital cardiac lesions, such as single ventricular anatomy6, conotruncal defects7 and the heterotaxy complexes8.…”

Use of CT angiography in the diagnosis of total anomalous venous return

“…6 Rapid diagnosis and surgical correction by anastomosis of the pulmonary venous trunk to the left atrium is crucial in reducing morbidity and mortality from this lesion. Although fetal diagnosis is accurate in 85 to 90% of pregnancies with CHD, 7,8 abnormalities of the aortic arch (such as coarctation) and pulmonary veins (isolated TAPVR without complex CHD) are more likely to be missed. In the absence of obstruction, as in supradiaphragmatic connections (case 2), patients may not present urgently during the neonatal hospitalization.…”