A Prospective Cohort to Evaluate Second-trimester Fetal Echocardiography Accuracy and to Evaluate Perinatal Outcomes in Iran

Abstract

Background: Congenital heart defects (CHDs) are the most costly congenital disorders and despite significant advances in the diagnostic modalities, still its perinatal and neonatal consequences require extensive studies. In the current study, we investigated diagnostic value of fetal heart echocardiography for CHDs diagnosis while postnatal echocardiography was considered as Gold standard. Additionally, maternal and perinatal outcomes were evaluated.
 Methods: In this prospective Cohort study, 400 high risk pregnant women with regards to carrying a fetus with CHDs underwent fetal echocardiography during pre and postnatal period and maternal, fetal and neonatal outcomes were followed. Moreover, diagnostic value of fetal echocardiography for predicting CHDs was calculated.
 Results: Among 400 fetal echocardiographies done, CHDs was found in 63 fetuses and consequently postnatal echocardiography confirmed the diagnosis in 52 (82.53%) of them. The most common CHDs were atrial and ventricular septal defects (ASD and/or VSD). Although there were no association between presence of CHDs with consanguineous marriage, maternal age, maternal body mass index, smoking, pregnancy complications, fetal weight, gestational age, neonatal gender, and associated anomalies, the first and fifth Apgar Scores were significantly lower in neonates with CHDs on postnatal echocardiography.
 Conclusion: Second trimester fetal echocardiography, especially among high risk mothers has high diagnostic value for fetal CHDs diagnosis. This Imaging technique can lessen postnatal complications by facilitating early diagnosis and subsequent planned delivery in a proper well-equipped center.