Prenatal diagnosis of congenital heart diseases: retrospective analysis of 11.068 fetal echocardiograms applied between 2007-2017

Aim: Fetal echocardiography is recommended for pregnant women whose fetuses are at high risk for congenital heart disease. However, heart defects may be diagnosed in fetuses without risk factors identified in the guidelines. In this study, we retrospectively analyzed the indication of fetal echocardiography, echocardiography results, the frequency and distribution of fetal heart abnormalities according to low and high risk factors. Materials and Methods: The records of 9721 fetuses who underwent fetal echocardiography and 2965 babies who underwent postnatal transthoracic echocardiography between January 2007 and December 2017 in the Pediatric Cardiology Department of Çukurova University Faculty of Medicine were retrospectively evaluated. Pregnants were divided into two groups as high / moderate risk (group 1) and low risk (group 2) for fetal heart anomalies according to the indications. Results: A total of 11,068 echocardiographies were performed on 9721 fetuses between 2007 and 2017 in our clinic. The gestational week at which the first examination was performed was between 12-41 weeks (24,7 ± 4,3). Of the total 9721 fetuses, % 42,9 belonged to group 1 and % 57,1 belonged to group 2. The first three reasons for admission were screening (% 50,6), suspicion of cardiac anomaly during routine ultrasonography (% 10,3), and cardiac anomaly in the previous fetus or sibling (% 7,4).The rate of fetal congenital heart disease was % 11,1 in all fetuses, % 20 in group 1 and % 3,9 in group 2. The most common cardiac anomalies detected in fetuses were ventricular septal defect, hypoplastic left heart syndrome, double outlet right ventricle. Among the diagnosed fetal heart defects; % 41,7 were not previously suspected cases. Compliance of prenatal and postnatal results was % 94,8. Conclusion: The frequency of congenital heart disease in the prenatal period is higher than the postnatal period. We found the highest rate of fetal heart anomaly in high-risk pregnancies as expected. However, in a significant number of fetuses diagnosed with congenital heart disease (% 41,7), the absence of any prior suspicion of cardiac abnormality suggests the importance of fetal heart screening. Keywords: Fetal echocardiography, Congenital heart diseases, Risk factors, Prenatal diagnosis.