Background
Congenital heart disease (CHD) is the most common congenital anomaly
that occurs in 8–12 per 1000 live births [1]. Several risk factors
have been incriminated in the pathogenesis of CHD [2]. These include
consanguinity [3], maternal medical illnesses [4], teratogenic
exposures [5], fetal chromosomal and extra-cardiac abnormalities
[6].
The impact of prenatal diagnosis of CHD on the postnatal outcomes has
been controversial. Several studies have shown that it decreased
neonatal morbidity and mortality; usually of the duct-dependent types
[8] as it provides the opportunity for a controlled elective
delivery at a tertiary care center with a specialized perinatal cardiac
and cardio-thoracic surgical services [9]. Moreover, it helps the
detection of concomitant fetal chromosomal and extra-cardiac anomalies,
assists in antenatal and postnatal management planning and offers better
parental counseling [10]. Other studies found no benefit on neonatal
outcomes [11]. Fetal echocardiography (FE) is also the most widely
used diagnostic modality for the detection of fetal arrhythmias [12]
and evaluation of its consequences such as valve regurgitation,
myocardial dysfunction and development of hydrops fetalis [13] FE is
used to detect cardiac anomalies in high risk specific cases [14];
though its use as a routine screening tool for all pregnancies is still
not well-established [15].
Most of the referrals are still based on the presence of abnormal 4
chamber view on obstetric ultrasound scan, anomaly scan or the presence
of a favoring prenatal risk factor despite that only 10% of the
affected children have such an identifiable predisposing factor
[16]. In this study, 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. We also aimed
to study the different kind of indications of referral and find out the
perinatal outcome, study the percentages of different type of cardiac
anomalies detected in fetal echocardiography and tried to find out
discrepancies between anomaly scan and fetal echocardiography as well as
tried to calculate sensitivity and specificity of fetal echocardiography
in detecting different kind of cardiac anomalies.