Prenatal detection of congenital heart disease: factors affecting obstetric management and survival.
Our recent experience in the diagnosis and management of fetal congenital heart disease is presented. During an 18-month period from January 1985 to June 1986, 1757 fetal echocardiograms were performed on a total of 989 antenatal patients. Cardiac anomalies were accurately predicted in 74 cases, 34 of which were associated with extracardiac or chromosomal anomalies. Twenty-three pregnancies were electively terminated. Currently the survival rate for ongoing pregnancies is 17%. A false negative diagnosis was made in 16 cases, the majority involving minor anomalies with a good prognosis and a survival rate of 81%. Prenatal detection of congenital heart disease places the fetus at high risk for chromosomal and extracardiac anomalies. Congenital heart disease detectable during pregnancy is usually severe and associated with a poor long-term prognosis. Termination of the pregnancy may be a reasonable option if a severe anomaly is detected early in pregnancy.
Crawford
D C
DC
British Heart Foundation Centre for Perinatal Cardiology, United Medical School, Guy's Hospital, London, England.
Chita
S K
SK
Allan
L D
LD
D004452:Echocardiography; D005188:False Negative Reactions; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000628:therapy; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006343:Heart Septal Defects / Q000175:diagnosis; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011379:Prognosis