Study on diagnosis of fetal congenital heart disease by echocardiography and integrated management in a single center in northwestern region of China

Abstract

Objective To explore the detection rate, types, accompanying abnormalities and prognosis of fetal congenital heart disease(CHD) in a single center in northwest China, in order to set up a foundation for further studying the epidemiological characteristics of fetal CHD and integrated management of fetal CHD in the prenatal and postnatal. Methods A total of 2 725 CHD in 45 015 fetus diagnosed by fetal echocardiography were enrolled. The fetal CHD detection rate and the composition ratio were calculated. Follow-up results between the simple CHD and complex CHD were analyzed. Results The detection rate of fetal CHD in our center was up to 6.1%. There were 1 589 cases of complex CHD, accounting for 58.3% in all the fetal CHD, of which the most common type was single ventricle, followed by tetralogy of Fallot, atrioventricular septal defect and double outlet right ventricle; Simple CHD 1 136 cases, accounting for 41.7% in all the fetal CHD, the most common type was ventricular septal defect. The number of abortion cases, intrauterine and postnatal natural deaths of fetal CHD accounted for 60.3% (1 357/2 251) of the total follow-up, of which complex CHD and chromosomal abnormalities accounting for the majority. 68 cases of CHD underwent surgical treatment after birth, of which complex CHD were predominant. 37 cases of simple CHD spontaneous closure and 27 cases of simple CHD genetic test results were abnormal. Conclusions The detection rate of CHD in this group is relatively high, which is related to the prenatal diagnosis consultation center. Fetal complex CHD is more common while the prognosis is worse than simple CHD. Prenatal and postnatal integrated management of fetal CHD has important clinical value in early treatment of complex CHD. Key words: Echocardiography; Congenital heart disease; Fetal; Integrated management