Role of Echocardiography in Prenatal Screening of Congenital Heart Diseases and its Correlation with Postnatal Outcome.

Abstract

Congenital Heart Defects (CHDs) are one of the most common forms of congenital anomalies. Fetal echocardiography performed during second trimester aims at early diagnosis of congenital heart disease which is instrumental in proper planning of delivery, perinatal care and counselling of parents. To evaluate the role of fetal echocardiography in prenatal screening of CHDs and to study the role of associated extracardiac anomalies. This was a hospital based prospective and correlative type of study, done over a period of one year. Antenatal screening of fetal heart was done in mid-trimester high and low risk pregnancies. The prenatal echo findings were co-related with postnatal findings in case of any abnormality detected. The extra-cardiac anomalies associated with positive cases were evaluated and studied for their impact on postnatal outcome. A total of 1200 pregnancies were screened out of which 672 were low risk and 528 were high risk. The cases with abnormal echo findings were followed postnatally. The overall incidence of CHD in study population was 15 per 1000. The incidence in high and low risk pregnancies were 16.3 and 13.25 per thousand respectively. Complete agreement of 68.17% was found between prenatal and postnatal findings. The most frequent Extra-Cardiac Anomalies (ECA) in cases with CHD was of musculoskeletal system. The CHD cases with ECA were significantly of low birth weight, born preterm and delivered by Lower Segment Caesarean Section (LSCS). Fetal heart is the most overlooked part in every routine anomaly scan. We conclude that fetal echocardiography should be an integral part of every second trimester anomaly scan for all pregnant females irrespective of their risk factors. The associated ECAs are another factor that causes increased mortality both in antenatal and neonatal life, again warranting an early fetal echo.