What is the clinical evidence from this study?

Study design: Observational. Population: Fetal cardiac anomalies (n=92). Intervention: Prenatal fetal echocardiography vs. Postnatal echocardiography. Primary outcome: Diagnostic concordance between prenatal and postnatal cardiac diagnoses in live-born infants.

What does this research mean for the field?

Prenatal echocardiography demonstrates a high diagnostic concordance (87.8%) with postnatal echocardiography for fetal cardiac anomalies, with inconsistencies primarily limited to small or muscular ventricular septal defects. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The research evaluates how accurately prenatal cardiac anomalies are diagnosed compared to postnatal assessments, and it analyzes the outcomes of those pregnancies.

June 14, 2026Koşuyolu Heart Journal0 citationsOpen Access

Prenatal Diagnosis of Fetal Cardiac Anomalies: Diagnostic Concordance with Postnatal Echocardiography and Perinatal Outcomes

AYAylin YilmazSahlgrenska University Hospital FGFatih Alparslan GençKartal Koşuyolu High Specialization Training and Research Hospital DKDidar KurtDr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi

Key Result

Prenatal fetal echocardiography demonstrated an 87.8% diagnostic concordance with postnatal echocardiography among live-born infants with structural cardiac anomalies.

Key Points

The research evaluates how accurately prenatal cardiac anomalies are diagnosed compared to postnatal assessments, and it analyzes the outcomes of those pregnancies.
Retrospective analysis of 9,755 fetal echocardiographic examinations.
Included 92 fetuses diagnosed with structural cardiac anomalies between January 2019 and May 2025.
Examined characteristics, anomalies, pregnancy outcomes, and postnatal echocardiography results.
Prenatal and postnatal diagnoses agreed in 72 out of 82 live births (87.8%).
Inconsistencies arose in 10 cases, mainly with small muscular ventricular septal defects.
Eleven postnatal deaths occurred, highlighting the severity of the cases.

Study Design

Type

Observational (n=92)

Multicenter

Structured PICO

Does prenatal fetal echocardiography accurately diagnose fetal cardiac anomalies compared to postnatal echocardiography?

Population

92 pregnant women (mean age 29.9 years) with prenatally detected fetal structural cardiac anomalies, followed through delivery to assess diagnostic concordance with postnatal findings.

Exposure

Prenatal diagnosis via fetal echocardiography

Comparator

Postnatal echocardiography

Outcome

Concordance between prenatal and postnatal cardiac diagnoses in live-born infants

Prenatal fetal echocardiography demonstrates high diagnostic concordance (87.8%) with postnatal findings, enabling early detection of severe anomalies and informed perinatal management.

Limitations

Retrospective design led to the exclusion of some cases due to incomplete records.
Postnatal follow-up is still ongoing for a proportion of patients, precluding a comprehensive evaluation of long-term morbidity and mortality.
The overall number of cases was limited, reflecting the relative rarity of prenatally diagnosed congenital cardiac anomalies.

Abstract

Objective: This study aimed to evaluate the concordance between prenatal and postnatal diagnoses in pregnant women with detected fetal cardiac anomalies and to present the perinatal outcomes of these pregnancies. Methods: A total of 9,755 fetal echocardiographic examinations performed at our hospital’s perinatology clinic between January 2019 and May 2025 were retrospectively analyzed. Ninety-two fetuses with structural cardiac anomalies identified during these examinations were included in the study. Maternal demographic characteristics, prenatal ultrasound and echocardiographic findings, the presence of accompanying extracardiac or genetic anomalies, pregnancy outcomes, and postnatal echocardiography results were examined. The concordance between prenatal and postnatal cardiac diagnoses in live-born infants was analyzed. Results: The mean gestational age at diagnosis was 23.07±4.15 weeks. Septal defects were the most common cardiac anomalies (45.7%), followed by conotruncal defects (18.5%) and left-sided obstructive lesions (15.2%). Due to severe cardiac and/or associated extracardiac or genetic anomalies, pregnancy was terminated in 10 cases (10.9%). Prenatal and postnatal cardiac diagnoses were consistent in 72 of the 82 live births (87.8%), whereas inconsistencies were detected in 10 cases (12.2%). These inconsistencies were most commonly associated with small or muscular ventricular septal defects. Eleven deaths were observed in the postnatal period. Conclusion: Prenatal diagnosis of fetal cardiac anomalies is important for the early detection of associated structural and genetic anomalies. Accurate diagnosis supports informed decision-making regarding the continuation or termination of pregnancy. Furthermore, early diagnosis of severe cardiac defects allows delivery to be planned in well-equipped centers and enables rapid postnatal intervention, which may positively influence neonatal outcomes. These findings emphasize the importance of prenatal echocardiography and a multidisciplinary approach in the perinatal management of congenital heart disease.

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