title: Evaluation of prenatal diagnosis of congenital heart disease in a regional controlled case study.
abstract: OBJECTIVE
  This study evaluated the evolution of the prenatal diagnosis of congenital heart disease (CHD) between 2003 and 2008 and its repercussion for the CHD prevalence rate at birth in a well-defined population (Canton of Vaud, Switzerland).
  
  
  RESULTS
  All 572 cases of CHD reported in the Eurocat Registry of Vaud-Switzerland between 1.5.2003 and 31.12.2008 were analysed and compared with the cases in our clinical database. CHD cases were divided into five different groups according to heart disease severity. The prenatal detection rates increased significantly between 2003 and 2008, with a mean detection rate of 25.2%. There was a significantly higher rate of prenatal diagnosis in the first four groups of CHD severity, with the highest detection rate (87.5%) found in the group with the most severe CHD (group 1). In this group, 85.7% of cases resulted in a termination of pregnancy, and there was a consequent 75% reduction in the prevalence of severe major cardiac malformation at birth. Detection rates were 66% in group 2, 68.6% in group 3, and the lowest in groups 4 and 5, with rates of 25.9% and 12.9%, respectively.
  
  
  CONCLUSIONS
  This study shows that the prenatal detection rate for CHD increased in a well-defined population over the study period. Prenatal diagnosis thus has had a major impact on patients with the most severe types of CHD and has resulted in a significant reduction in severe CHD at birth.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Rossier
authors.affiliation: Division of Pediatric Cardiology, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Mivelaz
authors.affiliation: Department of Medical Genetics, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Addor
authors.affiliation: Division of Pediatric Cardiology, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sekarski
authors.affiliation: Pediatric Cardiology, Medical School Twente, MST, Enschede, The Netherlands.
authors.forename: Erik Jan
authors.initials: EJ
authors.lastname: Meijboom
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vial
mesh_terms: D000025:Abortion, Eugenic / Q000706:statistics & numerical data; D004452:Echocardiography; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013557:Switzerland; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*