Fetal Cardiac Disease: The Pathologist's Perspective

In the European Union, it is estimated that 36,000 children are born every year with congenital heart disease and that a further 3000 who are diagnosed with congenital heart disease die as a result of termination of pregnancy, late fetal death or early neonatal death. In a normal population, the risk of a woman having a child with a congenital heart malformation is of the order of 0.8–1%, the risk rising to 2–3%, if a previous pregnancy was affected by heart disease and approaching 6% if the mother herself has a congenital heart defect. There is great variation between countries in the antenatal detection of heart defects, being lowest in those countries without ultrasound antenatal screening programmes (8–11%), but in Western Europe the detection rates vary between 19% and 48%. High-resolution echocardiography enables assessment of precise structures during the second trimester or even earlier.