Prenatal Detection of Congenital Heart Disease in Southern Nevada

Acherman, Ruben J.; Evans, William N.; Luna, Carlos Feitosa; Rollins, Robert C.; Kip, K. T.; Collazos, Juan C.; Restrepo, Humberto; Adasheck, Joseph; Iriye, Brian; Roberts, Donald F.; Sacks, Alan J.

doi:10.7863/jum.2007.26.12.1715

Cited by 75 publications

(89 citation statements)

References 35 publications

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“…Although the utility of prenatal detection of structural and functional cardiac pathology has been demonstrated and the cost benefit of prenatal over postnatal diagnosis also suggested [146,147], less than half of significant congenital heart disease is detected prenatally in North America and abroad even in larger cities remain low [148][149][150]. This is despite the fact that more than 95% of major structural and functional heart disease can be identified before birth and that the vast majority of pregnancies have a screening obstetrical ultrasound [148][149][150].…”

Section: Impact Of and Barriers To Fetal Cardiac Diagnosismentioning

confidence: 99%

“…This is despite the fact that more than 95% of major structural and functional heart disease can be identified before birth and that the vast majority of pregnancies have a screening obstetrical ultrasound [148][149][150]. It is well established that of all indications for fetal echocardiography, the one which results in the greatest yield of fetal heart disease is detection of cardiac or extracardiac pathology at routine obstetrical ultrasound screening in otherwise low risk pregnancies [151].…”

Section: Impact Of and Barriers To Fetal Cardiac Diagnosismentioning

confidence: 99%

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Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Hornberger

Moon‐Grady²,

Tworetzky³

2012

J Clin Exp Cardiolog

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Fetal echocardiography has evolved considerably over the past 1-2 decades into an exciting field that bridges maternal-fetal medicine with neonatology and pediatric cardiology. With significant advances in imaging technology and experience in prenatal diagnosis, details of the cardiac pathology can now be defined much as it is postnatally; however, unique aspects of the fetal circulation limit our ability to consistently define lesion severity and to predict the evolution of cardiac defects after birth. Serial assessment has provided an understanding of the antenatal natural history of fetal heart disease, which has led to improved counseling and perinatal/neonatal management strategies. More recently, this field has focused on improving our evaluation of fetal arrhythmias, exploring the pathophysiology of fetal heart failure, detecting heart defects at earlier gestational ages, identifying novel interventions to alter the development and progression of severe disease, and investigating strategies to optimize prenatal and neonatal care in an effort to improve perinatal outcome of affected pregnancies. In this paper we will review the current state of the art of fetal/perinatal cardiology and the advances that have occurred in the field largely over the past decade.

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Section: Impact Of and Barriers To Fetal Cardiac Diagnosismentioning

confidence: 99%

Section: Impact Of and Barriers To Fetal Cardiac Diagnosismentioning

confidence: 99%

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Hornberger

Moon‐Grady²,

Tworetzky³

2012

J Clin Exp Cardiolog

View full text Add to dashboard Cite

show abstract

“…Despite recognized benefits of prenatal CHD diagnosis and near universal availability of prenatal ultrasound [6][7] , recent single center studies and focused regional efforts suggest that prenatal detection rates (PDRs) for CHD remain low in the United States [8][9][10][11][12][13] . In other countries, large scale assessments using birth registries have identified significant regional variability of prenatal CHD diagnosis [14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

2015

PEDIATRICS

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“…21 On the other hand, the outflow tract views (OFTVs), when added to the 4CV, improve the sensitivity for major forms of CHD. 20,[22][23][24][25][26] Nevertheless, in part because the 4CV appears easier to obtain than the OFTVs, 2,17 the 4CV has remained the central focus of current approaches to prenatal screening for CHD. 22 Current formal guidelines emphasize the importance of the 4CV, recommending an attempt to include the OFTVs "when technically feasible."…”

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confidence: 99%

Prenatal Screening for Major Congenital Heart Disease

Sklansky

Berman

Pruetz

et al. 2009

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to determine the relative importance of the 4-chamber view (4CV) compared with the outflow tract views (OFTVs) in prenatal screening for major congenital heart disease (CHD). Methods. We prospectively evaluated 200 consecutive infants undergoing cardiac surgery at our institution for major CHD. By reviewing the infants' medical records and conducting bedside interviews with their parents or guardians, we evaluated detection rates both prenatally and postnatally (before and after discharge to home), and we noted any prenatally identifiable risk factors for CHD. For each infant, we determined whether the 4CV or OFTVs would be expected to have been normal or abnormal on routine midgestation screening fetal sonography. Results. A prenatal diagnosis of CHD was made in 65 infants (33%): 30 of 124 low-risk pregnancies (24%) and 35 of 76 high-risk pregnancies (46%). An abnormal screening midgestation 4CV would have been expected in up to 63% of the infants, whereas abnormal midgestation OFTVs would have been expected in up to 91% of the infants. Thus, the potential sensitivity for detecting major CHD was higher with the OFTVs than with the 4CV (91% versus 63%; P < .001). Moreover, the OFTVs were more sensitive than the 4CV for detecting ductaldependent forms of CHD. Diagnosis after discharge to home occurred in 39 of 135 postnatal diagnoses (29%), including many cases of isolated outflow tract abnormalities requiring early invasive intervention. Conclusions. Cases of major neonatal CHD with OFTV abnormalities predominate over cases with 4CV abnormalities, particularly among those forms of CHD requiring early invasive intervention.

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Prenatal Detection of Congenital Heart Disease in Southern Nevada

Abstract: Standard prenatal ultrasound fails to show congenital heart disease in most fetuses.

Cited by 75 publications

References 35 publications

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Variation in Prenatal Diagnosis of Congenital Heart Disease in Infants

Prenatal Screening for Major Congenital Heart Disease

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