Clinical significance of fetal echocardiography in diagnosing congenital
cardiac anomalies: an experience from eastern India
Abstract
Background: The role of early diagnosis of fetal cardiac abnormalities
(both structural and functional) on the postnatal outcome has been
controversial in literature for decade. Our objective was to evaluate
the role of fetal echocardiography (FE) as a diagnostic tool for early
detection of fetal cardiac abnormalities and its appropriate management
plan. Results: This is a cross-sectional analytical and descriptive
study that included 4366 singleton pregnant women (4366 fetuses)
referred for FE from 2014 to 2022. Indications for referral and
perinatal risk factors were documented. FE and postnatal transthoracic
echocardiography were done. Maximum number of fetal echo done for the
indication of presence of ICEF (1538, 35.2%). Routine FE done in 1199
(27.5%) individual. In 501(11.5%) individual had bad obstetric
history. Fetal cardiac abnormalities were detected in 175 fetuses (4%).
CHDs in 149 (3.4%), fetal arrhythmia in 17 (0.4%)cardiomyopathy in 3
(0.07%) fetuses and cardiac mass (Rhabdomyoma) in 6 fetuses (0.14%).
Of the structural CHDs, maximum number of cases were large VSD, found in
24 (13.7%) cases, Four cases with tiny muscular ventricular septal
defects and two cases with coarctation of aorta, one case of TGA with
IVS and one case of large VSD were missed by FE and were diagnosed
postnatal. Six cases of critical congenital heart disease were underwent
early lifesaving neonatal intervention. Conclusions: FE can accurately
diagnose most of the cardiac anomalies though few errors remain
challenging (aortic coarctation). It also offers a good chance for
successful early life saving management of some types of cardiac
lesions.