INDICATION GUIDELINES FOR FETAL ECHOCARDIOGRAPHY AND THEIR INFLUENCE ON PRENATAL DIAGNOSIS OF A HEART DISEASE
Rea Levicki, Slavica Sović, Ivan Malčić
Descriptive study: Fetal echocardiography indications and their role in the development of congenital heart defects in newborns. Hypothesis: Congenital heart defects (CHDs) are the most common birth defects diagnosed with the aid of fetal echocardiography (FE) in pregnant women with certain risk factors for CHD, enabling early treatment. Aim: of this study was to determine the connection between the indications which prompted physicians to refer pregnant women for FE and the CHDs caused by these indications. Results: The study involved 1374 pregnant women with 1380 pregnancies, referred by their primary gynecologist and examined in the Fetal cardiology clinic of theUniversity Hospital Centre Zagreb, Croatia, between the 1st January 2012 and the 1st January 2015. Most indications for FE were determined by obstetricians, while some pregnant women were referred for FE by their rheumatologist, genetic medicine specialist or physicians of other subspecialties. A few pregnant women were examined at their own request. The incidence of CHD was 14.2% (196 fetuses were diagnosed out of 1380 examined), the most common being ventricular septal defect (25%), complex CHD (15.3%), arrhythmia (14.79%), cardiomyopathy (10.71%), coarctation of the aorta (7.65%), aortic valve stenosis (6.12%) and bicuspid aortic valve (3.06%). Pathology was more likely to be detected in pregnant women referred for FE with a specific indication, in comparison to those sent for a routine examination. Conclusion: Fetal echocardiography is diagnostically most efficient if we adhere to the prescribed indications which may indicate a primary heart disease (CHD in family, arrhythmias, CMP), fetal syndrome disease, diabetes mellitus or gestational diabetes, and systemic diseases of the mother’s linking tissue (positive specific antibodies).