<scp>ISUOG</scp> Practice Guidelines (updated): sonographic screening examination of the fetal heart

Carvalho, J. S.; Ld, Allan; Chaoui, Rabih; Copel, JA; DeVore, G R; Hecher, Kurt; Lee, W; Muñoz, H.; Paladini, D.; Tutschek, B.; Yagel, Simcha

doi:10.1002/uog.12403

Cited by 571 publications

(460 citation statements)

References 81 publications

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“…Coarctation, in particular, is often missed, as evaluation of the aortic arch is not part of routine obstetric ultrasound screening. 18 Delivery in a nontertiary care setting and isolated CCHD were significantly associated with delayed diagnosis in a multivariate model. These findings are consistent with other recent studies.…”

Section: Discussionmentioning

confidence: 96%

Delayed Diagnosis of Critical Congenital Heart Defects: Trends and Associated Factors

et al. 2014

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OBJECTIVE: We aimed to examine trends in timing of diagnosis of critical congenital heart defects (CCHDs) and factors associated with delayed diagnosis (diagnosis after discharge home following delivery). METHODS: We examined a population-based retrospective cohort of CCHD cases among live births identified through the Massachusetts Birth Defects Monitoring Program. Congenital heart defects were considered critical if the infant received corrective surgery, interventional catheterization, palliative care, or died as a result of the defect within 12 months of birth. Timing of initial diagnosis was classified as prenatal, postnatal before discharge home, or delayed. Demographic, perinatal, and mortality information was obtained from the Registry of Vital Records and Statistics. Prevalence ratios (PRs) were used to examine associations with delayed diagnosis. RESULTS: Among 460 467 live births to Massachusetts residents between 2004 and 2009, we identified 916 CCHD cases, of which 126 (13.8%) had delayed diagnosis. Rates of prenatal CCHD diagnosis increased from 44.9% in 2004 to 63.8% in 2009, whereas rates of delayed diagnosis decreased from 17.1% to 10.6% over the same time period. Among cases with delayed diagnosis, the most common defects were coarctation, pulmonary valve stenosis, and tetralogy of Fallot. Delayed diagnosis was associated with delivery outside a tertiary hospital (adjusted PR: 3.6 [95% confidence interval: 2.5–5.2]) and isolated CCHD (adjusted PR: 1.7 [95% confidence interval: 1.1–2.7]). CONCLUSIONS: Despite increasing prenatal diagnosis of CCHDs, delayed diagnosis still occurs in over 10% of cases. Understanding factors associated with delayed diagnosis could help to improve prenatal and postnatal screening efforts, including pulse oximetry testing.

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Section: Discussionmentioning

confidence: 96%

Delayed Diagnosis of Critical Congenital Heart Defects: Trends and Associated Factors

et al. 2014

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“…We also identified 70 specific situations guidelines published between 2002 and 2014. Of these, 91% were from the USA,25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59 UK60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76 and Canada 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88. The remaining were from Australia,89 Brazil,90 Mexico,91 Poland,92 Spain93 and Uruguay 94…”

Section: Resultsmentioning

confidence: 99%

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Ábalos

Chamillard

Díaz

et al. 2015

BJOG

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BackgroundThe World Health Organization (WHO) is in the process of updating antenatal care (ANC) guidelines.ObjectivesTo map the existing clinical practice guidelines related to routine ANC for healthy women and to summarise all practices considered during routine ANC.Search strategyA systematic search in four databases for all clinical practice guidelines published after January 2000.Selection criteriaTwo researchers independently assessed the list of potentially eligible publications.Data collection and analysisInformation on scope of the guideline, type of practice, associated gestational age, recommendation type and the source of evidence were mapped.Main resultsOf 1866 references, we identified 85 guidelines focusing on the ANC period: 15 pertaining to routine ANC and 70 pertaining to specific situations. A total of 135 interventions from routine ANC guidelines were extracted, and categorised as clinical interventions (n = 80), screening/diagnostic procedures (n = 47) and health systems related (n = 8). Screening interventions, (syphilis, anaemia) were the most common practices. Within the 70 specific situation guidelines, 102 recommendations were identified. Overall, for 33 (out of 171) interventions there were conflicting recommendations provided by the different guidelines.ConclusionMapping the current guidelines including practices related to routine ANC informed the scoping phase for the WHO guideline for ANC. Our analysis indicates that guideline development processes may lead to different recommendations, due to context, evidence base or assessment of evidence. It would be useful for guideline developers to map and refer to other similar guidelines and, where relevant, explore the discrepancies in recommendations and others.Tweetable abstractWe identified existing ANC guidelines and mapped scope, practices, recommendations and source of evidence.

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“…Obstetric screening guidelines have improved, and in 2013, they were modified to include outflow tract imaging as a standard part of the evaluation. 7 Advances such as this one enable early detection of SVCHD and expedite timely referral for fetal echocardiography and consultation.…”

Section: Prenatal Detection Rates Of Congenital Heart Diseasementioning

confidence: 99%

Prenatal Counseling and Care for Single-Ventricle Heart Disease: One Center’s Model for Care

Lafranchi

Lincoln

2015

Critical Care Nurse

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Advances in prenatal imaging allow early detection of single-ventricle congenital heart disease, which may enhance prenatal care and maximize care options and decision making. Boston Children's Hospital's Advanced Fetal Care Center and fetal cardiology program provide prenatal counseling and care for single-ventricle congenital heart disease. Key points for optimal prenatal counseling and education include explanation of the diagnosis, delivery, the first surgery, cardiac neurodevelopmental issues, feeding and growth issues, quality of life and long-term care, family stressors, and fetal cardiac intervention. Such counseling and education help families make the difficult decisions required in this situation. (Critical Care Nurse. 2015;35[5]:53-61)

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ISUOG Practice Guidelines (updated): sonographic screening examination of the fetal heart

Abstract: You are viewing the old version of these guidelines. Click https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.26224 to read the updated guidelines.

Cited by 571 publications

References 81 publications

Delayed Diagnosis of Critical Congenital Heart Defects: Trends and Associated Factors

Delayed Diagnosis of Critical Congenital Heart Defects: Trends and Associated Factors

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Prenatal Counseling and Care for Single-Ventricle Heart Disease: One Center’s Model for Care

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