The accuracy of antenatal fetal echocardiography screening in high- and low-risk patients.
OBJECTIVE
The purpose of this study was to evaluate the accuracy of four-chamber and left ventricular outflow tract views in low-risk patients and comprehensive fetal echocardiographic examinations in high-risk patients to diagnose structural heart disease or thoracic anomalies.


METHODS
A prospective outcome study of two cohorts was performed; 1136 low-risk patients and 886 high-risk patients were evaluated during a 2-year period. Low-risk patients underwent routine four-chamber and left ventricular outflow tract evaluation whereas high-risk patients had detailed fetal echocardiographic examinations. Accuracy of the ultrasonographic diagnosis was evaluated from neonatal discharge data.


RESULTS
Only 2 of 14 patients with congenital heart disease in the low-risk group were correctly identified (sensitivity 14.3%) whereas 10 of 16 patients with congenital heart disease or thoracic anomalies were correctly identified in the high-risk group (sensitivity 62.5%).


CONCLUSIONS
The current study showed poor diagnostic accuracy of the standard four-chamber and left ventricular outflow tract views in low-risk patients for the diagnosis of structural cardiac anomalies. Patients with risk factors for congenital heart disease should be referred for comprehensive fetal echocardiographic examination.
Ott
W J
WJ
Department of Obstetrics and Gynecology, Saint John's Mercy Medical School, Saint Louis, MO, USA.
D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013909:Thorax / Q000002:abnormalities / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal