Fetal echocardiography for early detection of conotruncal anomalies in high risk pregnancies: One year follow-up

Abstract

Background: Fetal echocardiography (FE) has contributed in early identification of serious conotruncal anomalies that require early intervention in postnatal life. Objective: Our study aims to evaluate the incidence of development of conotruncal anomalies in pregnant women with high-risk pregnancies referred for extended FE. Subjects and Methods: One hundred and fifty-one pregnant mothers were referred between 2013 and 2014, from the feto-maternal clinic for FE in a pediatric cardiology unit, as they had risk factors for developing fetal cardiac anomalies. Results: Consanguineous marriage was reported in 62% of cases. Twelve studies (7.9%) showed abnormal cardiac examination, nine of which were outcomes of consanguineous marriage. Two cases had Ebstein anomaly; both cases were outcomes of consanguineous marriage, in one of them the mother received Aspirin during the 1st trimester. Another two cases were diagnosed as a muscular ventricular septal defect, one had a family history of congenital heart defects and was the outcome of consanguineous marriage, the other had a history of Aspirin administration during the 1st trimester and nonconsanguineous marriage, only one case had hypoplastic left heart syndrome, and the maternal age was 36 years. Six cases (3.9%) had fetuses with conotruncal anomalies; all were outcomes of consanguineous marriage. Conclusions: FE is valuable in early detection of serious defects as conotruncal anomalies that may require early peri-natal intervention, especially in cases with high risk. Positive consanguinity is a major problem in developing countries, possibly associated with serious problems in offspring.