P01.02: Evaluation of congenital cardiac findings in the group of high‐risk pregnancies

Abstract

To assess the accuracy of prenatal ultrasonography (US) for congenital heart defects (CHD) in the entire pregnant population undergoing US examination over a 10-year period. Study design: From 1/1990 to 12/2002, 30746 pregnant women underwent prenatal US examination inclusive of four-chambers view in all cases and ventricular outflow tracts in about 50% of cases. The operators were obstetricians with a different degree of experience in US (2 months-20 years). The prenatal detection rate (DR) of US in the detection of CHD was related to the type of anomaly and indications for the US exam (screening vs other indications/referral). All patients were followed until delivery or pregnancy termination. Clinical or autopsy confirmation of abnormal antenatal finding was obtained in all cases. Neonatal echocardiogram was performed in all babies admitted to NICU, in those with heart murmurs detected within 24 hours of birth, and in those with dysmorphic features. Obstetricians and neonatologists met weekly to discuss cases of cardiac anomaly diagnosed pre-or post-natally. Statistical analysis included Chi-square. Results: 313 cases of CHD occurred (1%), of which 228 (73%) were detected prenatally. The DR for the different subgroups of cardiac malformation were: 1) isolated septal defects: 44% (48/108); 2) atrio-ventricular canals: 95% (52/55); 3) isolated conotruncal defects: 88% (49/56); 4) malformations affecting the size of ventricles: 97% (55/57); 5) other malformations: 62% (23/37). The DR was 40% in screening scans (low-risk pregnancies) and 82% among referrals (p < 0001). Conclusion: In this largest cohort of prenatal screening for CHD, the DR was 73%. Septal defects contributed heavily to the false-positive results. The indication for the US scan significantly influences the sensitivity of the test. P01.02 Evaluation of congenital cardiac findings in the group of high-risk pregnancies