Recognition of congenital heart diseases with fetal echocardiography in the antenatal period and its effect on postnatal treatment

Akbarov E., Recognition of Congenital Heart Diseases with Fetal Echocardiography in the Antenatal Period and Its Effect on Postnatal Treatment. Başkent University Faculty of Medicine, Department of Pediatrics, Ankara 2024. Congenital heart diseases (CHD) are the most common group of congenital anomalies and cause significant morbidity and mortality in childhood. The aim of this study was to examine the prenatal, perinatal and postnatal characteristics of children diagnosed with CHD and to investigate the importance of fetal echocardiography in the diagnosis of CHD. For this purpose, babies who underwent fetal echocardiography at our center between September 2013 and August 2023 were included in the study. Demographic and clinical characteristics of the mothers, fetal echocardiography indications, echocardiography findings, CHD diagnoses, and clinical and prognostic features of babies diagnosed with CHD were evaluated retrospectively. 612 (52.5%) of 1165 babies were boys and 553 (47.5%) were girls. Pathological findings were detected in 35.3% (411/1165) of fetal echocardiograms, and the most common pathology was CHD (33.8%; 394/1165). CHD was confirmed in a total of 397 (34.1%) patients during the postnatal period. Ninety-eight (24.7%) patients had complex, 225 (56.7%) patients had significant, and 74 (18.6%) patients had minor CHD. Multivariate analysis revealed that multiple pregnancy (OR: 0.322, 95%CI: 0.210-0.494, p<0.001), chromosomal anomaly (OR: 0.067, 95%CI:0.009-0.506, p=0.009), non-cardiac anomaly (OR: 8.761, % 95CI:2.854-26.89, p<0.001), maternal heart disease (OR: 4.160, 95%CI:1.650-10.48, p=0.003), advanced maternal age (OR: 0.359, 95%CI:0.258-0.501, p<0.001), history of other diseases in the mother (OR: 3.992, 95%CI: 2.376-6.707, p<0.001), multiparity (OR: 1.859, 95%CI: 1.398-2.472, p<0.001) and consanguineous marriage (OR: 2.982, 95%CI:2.028-4.384, p<0.001) were independent predictors for CHD. Cardiac catheterization was performed in 52.9% of patients for management (29.2% diagnostic, 23.8% interventional). A total of 214 (57.8%) patients were operated on, 140 (37.8%) of the operations were performed in the neonatal period and 74 (20%) were performed in the post-natal period. The total mortality rate was 14.3%. Our study suggests that patients with prenatally diagnosed CHD are safely and better managed before interventions and surgery. Keywords: Congenital heart diseases, Echocardiography, Cardiac anomaly, Treatment.