title: A systematic review of prenatal screening for congenital heart disease by fetal electrocardiography.
abstract: BACKGROUND
  Congenital heart disease (CHD) is the most common severe congenital anomaly worldwide. Diagnosis early in pregnancy is important, but the detection rate by two-dimensional ultrasonography is only 65%-81%.
  
  
  OBJECTIVE
  To evaluate existing data on CHD and noninvasive abdominal fetal electrocardiography (ECG).
  
  
  METHODS
  A systematic review was performed through a search of the Cochrane Library, PubMed, and Embase for studies published up to April 2016 using the terms "congenital heart disease," "fetal electrocardiogram," and other similar keywords.
  
  
  METHODS
  Primary articles that described changes in fetal ECG among fetuses with CHD published in English were included.
  
  
  METHODS
  Outcomes of interest were changes in fetal ECG parameters observed for fetuses with congenital heart disease. Findings were reported descriptively.
  
  
  RESULTS
  Only five studies described changes observed in the fetal electrocardiogram for fetuses with CHD, including heart rate, heart rate variability, and PR, QRS, and QT intervals. Fetal ECG reflects the intimate relationship between the cardiac nerve conduction system and the structural morphology of the heart. It seems particularly helpful in detecting the electrophysiological effects of cardiac anatomic defects (e.g. hypotrophy, hypertrophy, and conduction interruption).
  
  
  CONCLUSIONS
  Fetal ECG might be a promising clinical tool to complement ultrasonography in the screening program for CHD.
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands. Electronic address: kimverdurmen@live.nl.
authors.forename: Kim M J
authors.initials: KM
authors.lastname: Verdurmen
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands.
authors.forename: Noortje B
authors.initials: NB
authors.lastname: Eijsvoogel
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands.
authors.forename: Carlijn
authors.initials: C
authors.lastname: Lempersz
authors.affiliation: Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
authors.forename: Rik
authors.initials: R
authors.lastname: Vullings
authors.affiliation: Department of Pediatrics, Máxima Medical Center, Veldhoven, Netherlands.
authors.forename: Christian
authors.initials: C
authors.lastname: Schroer
authors.affiliation: Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
authors.forename: Judith O E H
authors.initials: JO
authors.lastname: van Laar
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands; Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
authors.forename: S Guid
authors.initials: SG
authors.lastname: Oei
mesh_terms: D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005333:Fetus / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006339:Heart Rate; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D016216:Ultrasonography, Prenatal
keywords: Congenital heart disease; Fetal electrocardiogram; Fetal electrocardiography; Prenatal diagnosis; Prenatal screening