Considerations for Scaling Down Fetal Echocardiography During the COVID-19 Pandemic

The Mathematical Limitations of Fetal Echocardiography as a Screening Tool in the Setting of a Normal Second-Trimester Ultrasound

“…Future research should guide us on FE indications that meet these criteria. Our preliminary results 12 and those of other published studies 7 , 27 suggest that pre-gestational diabetes, family history, maternal medication, and isolated small increased nuchal translucency may not fulfill these criteria.…”

“…In 2018, we set up the Fetal Cardiac Registry of Quebec to Improve Resource Utilization in Fetal Cardiology (FREQUENCY) study, a large retrospective population-based study that aims to assess the performance of prenatal CHD screening in Quebec on > 650,000 mother–child dyads. 10 We used the preliminary results 11 , 12 of the FREQUENCY study to feed the initial assumption of our theoretical models: a prevalence of severe CHD of 1.82/1000 pregnancies, and a prevalence of high-risk pregnancies of 19.1/1000. The risk ratio of CHD in high-risk pregnancies cannot be calculated with the FREQUENCY study data.…”

A Focus on COVID-19: Fast and Accurate Information to Guide Management for Pandemic-Related Issues in Cardiac Patients

“…Cardinal et al provide preliminary evidence that the use of fetal echocardiography to screen for congenital malformations can be reduced greatly for patients with a normal second trimester scan, without missing severe congenital heart disease. 7 Marenzi and colleagues share their experience with tertiary inhospital management of acute coronary syndromes in the hard-hit Lombardy region of Italy, without units dedicated to isolation of COVID-19 patients. 8 Although the optimum is clearly to have all COVID-19epositive patients hospitalized in individual negative-pressure rooms geographically distinct from COVID-19efree subjects, this is often not possible in real-world conditions.…”