The role of regional prenatal cardiac screening for congenital heart disease: A single center experience

Pasierb, M.; Peñalver, Josiah M.; Vernon, Margaret M.; Arya, Bhawna

doi:10.1111/chd.12611

Cited by 4 publications

(3 citation statements)

References 18 publications

(29 reference statements)

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“…2 Nevertheless, a failed POxS is not specific for an exact cardiac diagnosis, and a passed POxS does not rule all forms of CCHD. 3 Alternatively, prenatal CCHD detection is both sensitive and specific 4,5 ; thus, prenatal diagnosis, in contrast to POxS, is the superior evidence-based diagnostic method. Additionally, prenatal diagnosis allows directed delivery at a facility with a congenital heart unit.…”

Section: Introductionmentioning

confidence: 99%

Detecting Critical Congenital Heart Disease in Nevada

Evans

Acherman

Ciccolo

et al. 2019

World J Pediatr Congenit Heart Surg

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Background: We reviewed data on patients born with critical congenital heart disease in the state of Nevada and analyzed detection via prenatal diagnosis versus newborn pulse oximetry screening, location of birth, and gestational age at birth. Methods: We inquired our databases and electronic health records for all patients with critical congenital heart disease born in Nevada between January 2016 and May 2019. Results: We identified 218 live born patients. Of the 218, average gestational age was 38 weeks (±2.2 weeks). Of the 218, 171 (78%) were prenatally diagnosed, 37 (17%) were diagnosed by immediate postnatal signs and symptoms, 8 (4%) had false-negative pulse oximetry screens that resulted in post-hospital discharge presentations, and 2 (1%) had positive pulse oximetry screens. The eight post-hospital discharge presentations included four in extremis, two with extreme cyanosis, and two dying at home. Of the 171 prenatally diagnosed patients, 157 (92%) were born at the Nevada hospital with the congenital cardiac unit. Conclusion: To the best of our knowledge, our results represent the highest statewide, general population prenatal detection of critical congenital heart disease in the United States. Our high prenatal detection rate led to the majority of patients being born at the Nevada facility with the congenital heart unit, limiting intrastate neonatal transports. On average, patients were born at term. Further, in Nevada, state-mandated, universal pulse oximetry screening resulted in more false-negative results than positive results

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Section: Introductionmentioning

confidence: 99%

Detecting Critical Congenital Heart Disease in Nevada

Evans

Acherman

Ciccolo

et al. 2019

World J Pediatr Congenit Heart Surg

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“…Therefore, such cases are best managed by paediatric cardiologists or cardiac surgeons. [14][15][16] In China, there are insufficient paediatric cardiac surgeons and resources are unevenly distributed. Most primary hospitals lack both suitable technology and doctors with experience in preventing, diagnosing and treating CHD.…”

Section: Discussionmentioning

confidence: 99%

The role of cardiac surgeons in online prenatal counselling for congenital heart disease

et al. 2019

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ObjectiveTo explore the role of cardiac surgeons in prenatal online counselling for congenital heart disease.MethodsFrom January 2014 to December 2017, the author consulted on 400 cases of foetal cardiovascular abnormalities through the Good Doctor Online and WeChat online platforms. The author made appropriate pregnancy recommendations to patients and families using patient ultrasound reports and medical histories. Followed-up patients who chose to continue their pregnancy received postnatal advice.ResultsThere were 248 simple cardiac abnormalities and 152 complex cardiac abnormalities. Foetal chromosome examination detected 2 cases of trisomy 21 syndrome and 26 normal cases. Two mothers (0.8%) of simple cardiac abnormality foetuses and 103 (67.8%) mothers of complex cardiac abnormality foetuses chose induced abortion. A total of 246 mothers of simple cardiac abnormality foetuses chose to continue pregnancy and had good postnatal prognosis. Twenty-six mothers of complex cardiac abnormality foetuses chose to continue pregnancy; among these, there were 4 intrauterine deaths, 22 births, 4 deaths while awaiting surgery and 18 successful surgeries.ConclusionThe Good Doctor Online and WeChat platforms facilitate communication with a wide audience. Cardiac surgeons can reduce the birth incidence and improve prenatal consultations for severe congenital heart disease through these platforms.

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“…The fetal echocardiographic diagnosis is the major determinant of decisions regarding pregnancy continuation, delivery location, and perinatal management planning. [1][2][3][4] High-quality fetal echocardiography is vital to complex medical decision-making, but the elements that drive quality and accuracy in fetal cardiac imaging are not well established. 5 Previous studies on diagnostic errors in fetal echocardiography have focused on the appropriateness of postnatal care planning on the basis of fetal echocardiography.…”

mentioning

confidence: 99%