Cardiac sonography by maternal-fetal medicine specialists achieved similar correct diagnostic accuracy for fetal CHD compared to pediatric cardiologists (73.6% vs 72.0%; P=.375-.832).
Observational (n=125)
No
Does prenatal CHD diagnosis by maternal-fetal medicine specialists have comparable accuracy to pediatric cardiologists in pregnancies with fetal CHD?
Maternal-fetal medicine specialists and pediatric cardiologists demonstrate high and comparable accuracy in prenatal congenital heart disease diagnosis, supporting the role of MFMs in primary screening.
Absolute Event Rate: 73.6% vs 72%
p-value: p=.375-.832
OBJECTIVE: This study compared the accuracy of prenatal congenital heart disease (CHD) diagnosed by maternal-fetal medicine specialists (MFMs) and pediatric cardiologists (PCs), using postnatal cardiac findings as the reference standard. METHODS: This retrospective analysis at Siriraj Hospital, Bangkok, Thailand, involved 125 pregnancies with fetal CHD diagnosed by MFMs and evaluated by PCs later. Prenatal CHD diagnoses by either MFM or PC were compared with postnatal diagnoses obtained through echocardiography, cardiac surgery/catheterization, or autopsy. Diagnostic accuracy was classified as (A) correct diagnosis, (B) minor differences not impacting clinical management or outcomes, or (C) major differences affecting prognosis or treatment. RESULTS: Cardiac sonography by MFM achieved diagnostic accuracies of 73.6% (A), 16% (B), and 10.4% (C), while fetal echocardiography by PC resulted in accuracies of 72% (A), 20% (B), and 8% (C). No statistically significant differences were found between MFM and PC in each category (P = .375-.832). The MFMs' accuracy was highest for tetralogy of Fallot (94.4%; 95% CI, 72.7-99.9%) and lowest for right atrial isomerism (71.4%; 95% CI, 29-96.3%) and pulmonary atresia with ventricular septal defect (57.1%; 95% CI, 18.4-90.1%). CONCLUSIONS: MFMs and PCs demonstrated high and comparable accuracy in prenatal CHD diagnosis. Although PCs tended to outperform MFMs in cases where misdiagnosis could significantly impact neonatal care and outcomes, MFMs can effectively perform primary screening for fetal CHD in all pregnancies. Collaboration with PCs remains essential when fetal CHD is suspected, particularly in complex cases.
Anuwutnavin et al. (Sat,) conducted a observational in Fetal congenital heart disease (CHD) (n=125). Cardiac sonography by maternal-fetal medicine specialists (MFMs) vs. Fetal echocardiography by pediatric cardiologists (PCs) was evaluated on Correct prenatal diagnosis compared with postnatal findings (p=.375-.832). Cardiac sonography by maternal-fetal medicine specialists achieved similar correct diagnostic accuracy for fetal CHD compared to pediatric cardiologists (73.6% vs 72.0%; P=.375-.832).