Changing indications for fetal echocardiography in a University Center population.
OBJECTIVE
We hypothesized that increased facility with fetal echocardiographic diagnosis by obstetricians is associated with changes in its indications and yields.


METHODS
We reviewed 300 fetal echocardiograms (December 2002-August 2003) and compared our findings with previous studies.


RESULTS
Mean maternal age was 31 +/- 6 (range 16-44) years. Gestational age was 24 +/- 5 weeks (mean +/- SD; median 22, range 15-38). Indications for fetal echocardiography included family history of congenital heart disease (CHD) (23%), maternal diabetes (18%), obstetrical scan suspicious for CHD (13%), arrhythmia (12%) maternal rheumatologic disease (7%), extracardiac congenital anomalies (6%), chromosomal anomaly (6%) and exposure to a potential fetal teratogen (5%). High yield indications included chromosomal anomaly (47%) and a suspicious obstetrical scan (42%). Low yield indications included family history of CHD (4%) and teratogen exposure (0%). 1/7 of the patients with increased nuchal translucency had pulmonary atresia/intact ventricular septum. No anomalies were associated with the single umbilical artery.


CONCLUSIONS
Indications and yields of fetal echocardiography have changed over the last decade. The frequency of an obstetrical scan suspicious for CHD has increased 2.5 to 3 times over a decade and continues to have high yield. Thus, increasing prenatal detection of CHD depends, to a large extent, on increasing the skills of obstetricians.
Friedberg
Mark K
MK
Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, CA, USA. mark.friedberg@stanford.edu
Silverman
Norman H
NH
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005333:Fetus / Q000002:abnormalities; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D012107:Research Design; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*