Has fetal echocardiography improved the prognosis of congenital heart disease? Comparison of patients with hypoplastic left heart syndrome with and without prenatal diagnosis

BACKGROUND: As prenatal diagnosis of congenital heart disease has gained in popularity, the questions of whether prenatal diagnosis of congenital heart disease is beneficial for the patient and whether fetal echocardiography has improved the prognosis of congenital heart disease are arising. METHODS: We compared four patients with prenatally diagnosed hypoplastic left heart syndrome (HLHS) with 10 patients of non-prenatally diagnosed HLHS from the view points of (i) age at transfer to our Children's Hospital; (ii) whether the oxygen was inhaled during perinatal period; (iii) whether prostaglandin E1 was administered in the period of waiting before operation; (iv) whether the patient had ductal shock; (v) timing of operation; and (vi) surgical outcome. RESULTS: The timing of the transfer to our Children's Hospital was earlier in prenatally diagnosed group than in non-diagnosed group. Oxygen was not given to any of the patients in prenatally diagnosed group. In contrast, oxygen inhalation was given in two of 10 patients in the non-prenatally diagnosed group. Prostaglandin E1 was administrated in three of four patients in the prenatally diagnosed group and seven of 10 patients in the non-prenatally diagnosed group. In terms of ductal shock, none of the patients in prenatally diagnosed group had ductal shock. However, four of 10 patients had ductal shock in the non-prenatally diagnosed group. The median age at Norwood operation was 7 days in the prenatally diagnosed group; however, it was 19 days in non-prenatally diagnosed group. Surgical outcomes showed no significant changes between the two groups. CONCLUSIONS: Prenatal diagnosis of HLHS was surely beneficial for preventing ductal shock and for keeping the patients' preoperative condition good.