title: Moving towards universal prenatal detection of critical congenital heart disease in southern Nevada: a community-wide program.
abstract: This study compares the current, prenatal detection rate for critical congenital heart disease in Southern Nevada with the previously reported rate, after developing and expanding a comprehensive, community-wide fetal cardiology program. For the current-period analysis, we inquired our database and electronic health records for patients born in Clark County, Nevada, with critical congenital heart disease between May 2012 and April 2014, and we compared the results with the previous period between May 2003 and April 2006. The major components of the community-wide program include fetal congenital heart disease screening via general obstetric ultrasound studies performed in obstetrician's offices, radiology imaging centers, or maternal-fetal medicine specialty practices; subsequent referral for comprehensive fetal echocardiography performed in maternal-fetal medicine offices under the on-site supervision by fetal cardiologists; and recurring community educational programs teaching the 5-axial plane, fetal echocardiographic screening protocol to general obstetric sonographers and instructing perinatal sonographers in advanced imaging topics. For the current period, the prenatal detection rate for critical congenital heart disease in Southern Nevada was 71 versus 36% for the previous period (p < 0.001). The temporal improvement in prenatal detection of critical congenital heart disease may be related to our expanded decentralized, community-wide fetal cardiology program, and our experiences may be applicable to other metropolitan areas.
authors.affiliation: Children's Heart Center Nevada, 3006 S. Maryland Pkwy Ste. 690, Las Vegas, NV, 89109, USA, wnevans50@aol.com.
authors.forename: William
authors.initials: W
authors.lastname: Evans
authors.forename: William
authors.initials: W
authors.lastname: Castillo
authors.forename: Robert
authors.initials: R
authors.lastname: Rollins
authors.forename: Carlos
authors.initials: C
authors.lastname: Luna
authors.forename: Katrinka
authors.initials: K
authors.lastname: Kip
authors.forename: Joseph
authors.initials: J
authors.lastname: Ludwick
authors.forename: Nitin
authors.initials: N
authors.lastname: Madan
authors.forename: Michael
authors.initials: M
authors.lastname: Ciccolo
authors.forename: Alvaro
authors.initials: A
authors.lastname: Galindo
authors.forename: Abraham
authors.initials: A
authors.lastname: Rothman
authors.forename: Gary
authors.initials: G
authors.lastname: Mayman
authors.forename: Kathleen
authors.initials: K
authors.lastname: Cass
authors.forename: Vincent
authors.initials: V
authors.lastname: Thomas
authors.forename: Humberto
authors.initials: H
authors.lastname: Restrepo
authors.forename: Ruben
authors.initials: R
authors.lastname: Acherman
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000175:diagnosis; D003153:Community Health Services; D004452:Echocardiography / Q000706:statistics & numerical data; D005315:Fetal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000002:abnormalities; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration / Q000706:statistics & numerical data; D009505:Nevada; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D013771:Tetralogy of Fallot / Q000175:diagnosis; D014188:Transposition of Great Vessels / Q000175:diagnosis; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data
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