Prenatal detection of congenital heart disease in southern Nevada: the need for universal fetal cardiac evaluation.
OBJECTIVE
Congenital cardiac malformations are common developmental anomalies. In the United States, congenital heart disease is the number one cause of infant mortality from congenital malformations. Prenatal diagnosis of congenital heart defects aids treatment coordination. Our aim was to evaluate prenatal detection of serious congenital heart malformations in Clark County, Nevada.


METHODS
We electronically searched our research department-maintained computer database for patients with serious congenital heart disease born in Clark County between May 2003 and April 2006. We excluded patients that did not have at least 1 local prenatal ultrasound examination. All pre-natal ultrasound studies were performed in obstetric offices, radiology imaging centers, or maternal-fetal medicine specialty practices. Fetal echocardiography was performed in maternal-fetal medicine specialists' offices under the supervision of a fetal cardiologist. Pediatric cardiologists performed all postnatal echocardiographic examinations.


RESULTS
During the study period, we diagnosed serious congenital heart malformations in 161 patients among a total estimated 77,000 births (2/1000). Of the 161 patients, 58 (36%) had a prenatal diagnosis, and 103 (64%) had an exclusively postnatal diagnosis.


CONCLUSIONS
Standard prenatal ultrasound fails to show congenital heart disease in most fetuses.
Acherman
Ruben J
RJ
Children's Heart Center, 3006 S Maryland Pkwy, Suite 690, Las Vegas, Nevada 89109, USA. iacherman@aol.com
Evans
William N
WN
Luna
Carlos F
CF
Rollins
Robert
R
Kip
Katrinka T
KT
Collazos
Juan C
JC
Restrepo
Humberto
H
Adasheck
Joseph
J
Iriye
Brian K
BK
Roberts
Donald
D
Sacks
Alan J
AJ
D004452:Echocardiography / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000191:economics / Q000401:mortality*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D009505:Nevada / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*