Effect of detailed fetal echocardiography as part of routine prenatal ultrasonographic screening on detection of congenital heart disease

Stümpflen, Ingrid; Stümpflen, Andreas; Wimmer, M; Bernaschek, Gerhard

doi:10.1016/s0140-6736(96)04069-x

Cited by 285 publications

(147 citation statements)

References 24 publications

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“…Obstetricians must be sensitized to the fact that the major proportion of prenatally detectable cases occur in a low risk population. [15] Hence, it is important to include imaging of the outflow tracts in addition to the four chamber view during routine scan which has shown to increase the detection rate of CHD. [16] The obstetricians should be trained to suspect heart disease e.g.…”

Section: Discussionmentioning

confidence: 99%

Awareness of fetal echo in Indian scenario

et al. 2012

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Background:Fetal echocardiography is a well established sensitive tool to diagnose congenital heart disease (CHD) in utero. One of the determinants of effective utilization of fetal echocardiography is its awareness in the general population. The present hospital based study was undertaken to assess the awareness of the need for fetal echocardiography amongst Indian parents.Methods:One thousand one hundred and thirty eight consecutive parents who visited the pediatric cardiology outpatient department of a tertiary care centre over a period of two months were asked to fill up a questionnaire that included their demographic data, educational status, history of CHD in children, awareness of fetal echocardiography and source of information and timing of fetal echocardiogram if performed. The data was categorized and awareness was noted in different groups.Results:The awareness in the study population was 2.2%. Awareness was found to be similar across the study population irrespective of the demographics and high risk status of the parents.Conclusions:The awareness of fetal echocardiography, an important tool in reducing the incidence of complex CHD, thereby impacting public health, is alarmingly low in the population studied. Appropriate action to increase awareness of fetal echocardiography needs to be looked into.

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Section: Discussionmentioning

confidence: 99%

Awareness of fetal echo in Indian scenario

et al. 2012

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“…A standard 4 chamber view can detect 40%–50% of major CHD [14], while a 4 chamber view and outflow tract detects 70%–80% of major CHD [15]. In dedicated fetal cardiac centres the diagnostic accuracy is close to 100% [4, 16]. Fetal cardiac malformations are compounded by the fact that other malformations may be present, as is the possibility of chromosomal abnormalities.…”

Section: Ethical Responsibility Of Cardiologists When a Serious Fementioning

confidence: 99%

Ethical Issues in Fetal Management: A Cardiac Perspective

Malhotra

Menahem

Gillam

2010

International Journal of Pediatrics

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The ethical issues behind the management of a fetus with a serious abnormality and the decisions made in relation to the outcome of the pregnancy are complex. This reflective paper deals with the ethical principles of managing a pregnancy with a congenital anomaly, with particular emphasis on the fetus with a serious cardiac abnormality. One major ethical concern is whether the fetus is or is not independent being to whom obligations of beneficence are owed. We review the debate on this matter, and suggest that it is ethically more appropriate for physicians who are involved in management of fetal abnormality not to adopt and insist on their own position on this matter. Rather, the appropriate course is to respect the pregnant woman's own view of her fetus and how it should be regarded. This is an application of the principle of respect for autonomy. Within this framework, we discuss the difficulties in counselling a pregnant woman or expectant couple in this situation, and recommend three key steps in ethically sound counselling.

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“…Whether such training is delivered by cardiologists with expertise in fetal diagnosis or obstetricians or sonographers with particular expertise will depend on local factors. It is also important to distinguish the detection rates that are reported by individual centers[56] from those that are population-based. [357] Individual center data will depend on the nature of the unit reporting their data, referral patterns, and the expertise within the unit.…”

Section: How and How Far To Train Sonographers To Examine The Fetal Hmentioning

confidence: 99%

Impact of fetal echocardiography

Simpson

2009

Ann Pediatr Card

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Prenatal diagnosis of congenital heart disease is now well established for a wide range of cardiac anomalies. Diagnosis of congenital heart disease during fetal life not only identifies the cardiac lesion but may also lead to detection of associated abnormalities. This information allows a detailed discussion of the prognosis with parents. For continuing pregnancies, appropriate preparation can be made to optimize the postnatal outcome. Reduced morbidity and mortality, following antenatal diagnosis, has been reported for coarctation of the aorta, hypoplastic left heart syndrome, and transposition of the great arteries. With regard to screening policy, most affected fetuses are in the “low risk” population, emphasizing the importance of appropriate training for those who undertake such obstetric anomaly scans. As a minimum, the four chamber view of the fetal heart should be incorporated into midtrimester anomaly scans, and where feasible, views of the outflow tracts should also be included, to increase the diagnostic yield. Newer screening techniques, such as measurement of nuchal translucency, may contribute to identification of fetuses at high risk for congenital heart disease and prompt referral for detailed cardiac assessment.

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Effect of detailed fetal echocardiography as part of routine prenatal ultrasonographic screening on detection of congenital heart disease

Cited by 285 publications

References 24 publications

Awareness of fetal echo in Indian scenario

Awareness of fetal echo in Indian scenario

Ethical Issues in Fetal Management: A Cardiac Perspective

Impact of fetal echocardiography

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