Prenatal detection of congenital heart disease occurred in only 13.3% of cases despite 99.7% obstetric follow-up, with future pregnancy counseling provided to just 31.2% of families.
What are the rates of prenatal CHD detection and predictors of counseling for fetal echocardiography in a developing country?
362 families of children with congenital heart disease (CHD) in a developing country
Prenatal ultrasound screening and fetal echocardiography
No prenatal screening / postnatal diagnosis
Prenatal CHD detection rate, fetal echocardiography utilization, and predictors of counseling for fetal echocardiography in future pregnancies
Prenatal detection of CHD in resource-limited settings is low (13.3%), highlighting significant gaps in screening and counseling that require better integration of obstetric and pediatric cardiology services.
ABSTRACT Objective Prenatal detection of congenital heart disease (CHD) remains suboptimal in resource‐limited settings. We quantified prenatal CHD detection, fetal echocardiography utilization, and predictors of counseling for fetal echocardiography in future pregnancies. Method We surveyed parents of children with CHD, capturing key sociodemographics, obstetric history, prenatal screening, use of fetal echocardiography, and future counseling. We compared prenatal versus postnatal diagnoses and used multivariable logistic regression to identify counseling predictors. Results Among 362 families, only 48 children (13.3%) were diagnosed prenatally, despite nearly universal obstetric follow‐up (99.7%) and moderate prenatal ultrasound screening (59.4%). Prenatal ultrasound screening was more frequent among prenatally diagnosed cases (97.9% vs. 53.5%; p < 0.001). Fetal echocardiography was more common when extracardiac malformations were suspected and in moderate‐to‐complex CHD ( p < 0.001). Only 113/362 (31.2%) of families reported receiving counseling for future pregnancies. In multivariable analysis, greater CHD complexity was independently associated with counseling (OR 3.21; p < 0.001), whereas family history of CHD was not ( p = 0.91). Conclusions Prenatal CHD detection was uncommon and driven by screening practices. Counseling regarding fetal echocardiography was inconsistently delivered and concentrated on complex CHD. These findings highlight gaps in referral and counseling, supporting the need for stronger integration between obstetric and pediatric cardiology services.
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Lina Hammoud
Rana Zareef
Jad Abdul Khalek
Prenatal Diagnosis
American University of Beirut
American University of Beirut Medical Center
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Hammoud et al. (Thu,) reported a other. Prenatal detection of congenital heart disease occurred in only 13.3% of cases despite 99.7% obstetric follow-up, with future pregnancy counseling provided to just 31.2% of families.
www.synapsesocial.com/papers/69d9e50778050d08c1b75581 — DOI: https://doi.org/10.1002/pd.70144
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