Clinical analysis of prenatal ultrasound diagnosis of fetal cardiovascular malformations in the first and second trimesters of pregnancy

Abstract

Fetal cardiovascular malformations is widely focused and screened, but the accuracy of screening is not satisfactory. In this study, we compared the types of congenital heart malformation, accompanying diseases and fetal outcomes in the first and second trimesters of pregnancy to clarify the advantage of early screening.From January 2013 to June 2018, 230 fetuses were diagnosed with congenital heart malformations using ultrasound method in Qilu Hospital of Shandong University, and divided into 2 groups:the first trimester fetuses (group A) and the second trimester fetuses (group B). In addition, we collected and organized medical data of 347 cases diagnosed with congenital heart disease during 1998 to 2005 (group C). We compared the spectrum of congenital heart disease, associated comorbidities and outcome of fetuses diagnosed with congenital heart disease.There were differences in the types and incidence of cardiac malformations between the first and second trimesters of pregnancy. The number of cases of non-cardiac malformation, congenital heart disease with single ventricular circulation, fetal intrauterine death and premature pregnancy termination was significantly lower in the late stage (group A and group B) than that in the early stage (group C). More patients were screened for trisomy 21, 18, 13 syndromes and Turner syndrome in group A than group B (P <.001). More fetuses with a 22q11 deletion were screened in group B than group C.Early pregnancy screening using ultrasound diagnosis is very important for fetuses with congenital heart disease.

Live-Birth Incidence of Isolated D-Transposition of Great Arteries—The Shift in Trends Due to Early Diagnosis

“…The prenatal diagnosis of any major CHD always raises the question of whether to terminate or to continue the pregnancy, and this decision will depend on a variety of factors [ 24 , 68 , 69 ].…”

Fetal echocardiography and early neonatal balloon valvuloplasty improved overall survival in prenatally detected aortic stenosis over 25 years of tertiary center experience

“…A typical image of aortic stenosis such as LV dysfunction, mitral regurgitation, endocardial fibroelastosis, and left to right flow across foramen ovale is usually present in late gestation above 26 weeks (Photo 2). 5,6 Freud et al assessed that the diagnosis of AS with a BV outcome in the prenatal period was made in 10 out of 117 newborns which constituted 8.5% of prenatal diagnoses. The fetuses with confirmed AS at an average gestational age of 21.6 weeks had antegrade flow across AV and peak velocity across AV (1–1.4 m/s).…”

Impacts of prenatal diagnosis of congenital heart diseases on outcomes

“…The first impact for severe CHD, and the most intuitive for the parents, is the interrogation on the outcome of the pregnancy. Indeed, the diagnosis of a CHD raises the question to terminate or to continue the pregnancy, and this decision will depend on a variety of factors (3)(4)(5). We will discuss briefly these determinants of termination of pregnancy after prenatal diagnosis of a CHD.…”