title: Evaluation of fetal echocardiography as a routine antenatal screening tool for detection of congenital heart disease.
abstract: BACKGROUND
  Fetal echocardiography plays a pivotal role in identifying the congenital heart defects (CHDs) in utero. Though foetal echocardiography is mostly reserved for high risk pregnant women, its role as a routine prenatal screening tool still needs to be defined. Performing foetal echocardiography based on only these indications can lead to a significant numbers of CHD cases going undetected who will be deprived of further management leading to increased early neonatal mortalities. The aim of this study is to assess the incidence of CHDs by fetal echocardiography in an unselected population of pregnant women in comparison with pregnant women with conventional high risk factors for CHD.
  
  
  METHODS
  This study enrolled consecutive pregnant women who attended antenatal clinic between 2008 and 2012 in a tertiary care hospital. These pregnant women were categorized into two groups: high risk group included pregnant women with traditional risk factors for CHD as laid down by Pediatric Council of the American Society of Echocardiography and low risk group. Detailed fetal 2 D echocardiography was done.
  
  
  RESULTS
  A total of 1,280 pregnant women were included in study. The 118 women were categorized as the high risk group while remaining 1,162 were included in the low risk group. Twenty six cases of CHDs were detected based on abnormal foetal echocardiography (20.3 per 1,000). Two of the 26 cases of CHD occurred in high risk group whereas the remaining 24 occurred in low risk pregnancy. The difference in the incidence of CHDs between the two groups was not significant statistically (P=0.76).
  
  
  CONCLUSIONS
  Our study shows no difference in incidence of CHDs between pregnancies associated with high risk factors compared to low risk pregnancies. So we advocate foetal echocardiography should be included as a part of routine antenatal screening and all pregnant women irrespective of risk factors for CHDs.
authors.affiliation: 1 SOAHS, Manipal University, Manipal, Karnataka, India ; 2 Department of Cardiology, Kasturba Medical College, Manipal University, Manipal, India ; 3 Kasturba Medical College, Manipal University, Manipal, India ; 4 Department Of Obstetrics And Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Krishnananda
authors.initials: K
authors.lastname: Nayak
authors.affiliation: 1 SOAHS, Manipal University, Manipal, Karnataka, India ; 2 Department of Cardiology, Kasturba Medical College, Manipal University, Manipal, India ; 3 Kasturba Medical College, Manipal University, Manipal, India ; 4 Department Of Obstetrics And Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Chandra G S
authors.affiliation: 1 SOAHS, Manipal University, Manipal, Karnataka, India ; 2 Department of Cardiology, Kasturba Medical College, Manipal University, Manipal, India ; 3 Kasturba Medical College, Manipal University, Manipal, India ; 4 Department Of Obstetrics And Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Shetty
authors.affiliation: 1 SOAHS, Manipal University, Manipal, Karnataka, India ; 2 Department of Cardiology, Kasturba Medical College, Manipal University, Manipal, India ; 3 Kasturba Medical College, Manipal University, Manipal, India ; 4 Department Of Obstetrics And Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Pratap Kumar
authors.initials: PK
authors.lastname: Narayan
keywords: Congenital heart disease (CHD); fetal echocardiography; prenatal diagnosis