The results of fetal echocardiography in a tertiary center and comparison of low- and high-risk pregnancies for fetal congenital heart defects

OBJECTIVE: Fetal echocardiography (FE) is considered for fetal, maternal or hereditary reasons in pregnants with suspect of intrauterine heart disease (IUHD). However, in few studies it was reported that most of the fetuses with IUHD are in the low-risk group (suspicion of IUHD during 2nd trimester ultrasound, lack of good vision of the heart, self-referral). Our aim is to examine retrospectively the reasons for referral of pregnants, the results of FE, distribution of pregnants having fetuses with IUHD according to low- and high- risk factors and to evaluate reliability of FE. METHODS: Our study group consisted of 1395 fetuses and 1370 pregnants underwent FE between 1999 and 2006. These cases included self-referred women and the pregnants having previous child or family history of cardiac anomaly or referred by obstetricians. The prevalence of IUHDs in low- and high- risk pregnancies was compared by Chi-Square test. RESULTS: The low risk group included 453 patients and the remaining 917 women were in the high- risk group. Intrauterine heart diseases were detected in 152 (10.9%) of 1395 fetuses. The prevalence of IUHDs was 19% in the low- risk group and 7% in the high-risk group. Of the 152 fetuses 56.6% were in the low-risk group and 43.4% were in the high- risk group. The sensitivity of FE for diagnose of IUHDs was 97%, the specificity was 100%. CONCLUSION: Fetal echocardiography is highly reliable method for diagnosing of IUHDs. The most IUHDs occur in the low- risk group.