Is Fetal Echocardiography Accurate Enough for Prenatal Diagnosis of Congenital Heart Diseases?

Introduction: Objective: Prenatal detection of congenital heart disease (CHD) using fetal echocardiography (FE) helps in early diagnosis leading to prompt management and treatment. FE provides a highly accurate non-invasive modality to improve the survival or quality of life of CHD patients. The aim of this study was to evaluate the antenatal detection of CHD by FE and compare it with the results of postnatal echocardiography. Methods: A prospective cohort study of pregnant women referred to a tertiary center Imam-Reza Hospital, Mashhad, Iran, for performing FE in the hands of an experienced pediatric cardiologist between 2012 and 2021. Cardiac echocardiography was performed by GE Vivid 7 color Doppler and Mindray Resona 7 color Doppler with convex probe 5-7 megahertz during late first trimester or early second trimester and after birth until 2 months later. Data were analyzed using SPSS and MedCalc software, and agreement was assessed using kappa. Results: Out of 261 studied fetuses, 101 normal cases were detected in full agreement with postnatal echo diagnosis. Acceptable diagnosis was found for septal defects; VSDs were highly statistically detected (sensitivity= 90%, specificity= 93%). Complex CHDs were found to be the most accurate prenatal diagnosis. Right arch anomalies, aortic stenosis, hypoplastic left heart syndrome and cardiac masses were perfectly acceptable, but detection of coarctation of the aorta faced with over-diagnosis. Prenatally diagnosed arrhythmias without structural defects, mostly premature beats, shifted to normal postnatal echo. Conclusion: FE is a safe and sensitive modality in prenatal diagnosis of CHDs. The study showed the effectiveness accuracy of early first trimester; also complete detection in both sides of the defect spectrum. [ABSTRACT FROM AUTHOR]