Impact of antenatal diagnosis on management of congenital heart diseases: A retrospective study from 2010 to 2015

Abstract

Congenital heart diseases (CHD) are a serious pathology, their prognosis is sometimes uncertain but they can be treated with rapid and adapted care at birth. The benefit of antenatal diagnosis is no longer demonstrable, since it significantly reduces morbidity and mortality. The aim of the study is to evaluate the cardiological consequences of antenatal screening of CHD, its impact on pregnancy outcomes and to determine the prognostic factors associated with early and late survival. A retrospective, monocentric study was performed at CHU Amiens, Picardie, between 2010 and 2015. 205 fetuses with CHD were included. Main outcome measures were the evolution in the performance of antenatal diagnosis, the impact of extracardiac abnormalities and pronostic factors of survival. Prenatal diagnosis rate of CHD increased from 41% in 2010 to 57% in 2015. Termination of pregnancy (TOP) rate has remained stable over time (25,8%). The prognostic factors associated with the outcome of pregnancy were extracardiac abnormalities (32% in TOP group versus 14.6% in the live neonates group, P < 0,01) and type of heart disease (64.1% univentricular cardiac disease in TOP group versus 35,8% in live neonates group, P < 0,01). Survival was 98% at 1 week and 93% at 1 year. The univentricular character of CHD and absence of surgical management were prognostic factors of survival ( P < 0.01). Progress in the antenatal diagnosis rate of CHD and reduction in neonatal mortality are due to close collaboration between the different actors of care. The long-term neurodevelopmental consequences must be evaluated.