Prenatal diagnosis of congenital heart disease in the northern region of England: benefits of a training programme for obstetric ultrasonographers

Hunter, Stewart

doi:10.1136/heart.84.3.294

Cited by 127 publications

(129 citation statements)

References 10 publications

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“…The recent significant decrease in the birth of babies with HLHS is an example for this situation (14). Hunter et al (8) found the termination rate in 1994 as 22.7% and in 1997 as 57%. Therefore, the prevalence of complex and serious CHD was reduced from 3.3/1000 live births to 2.6/1000 live births.…”

Section: Discussionmentioning

confidence: 99%

“…A modified classification system similar to that of Hunter et al (8) and Wren et al (9) was used in categorization of congenital heart defects ( Table 1). Category I included cardiac anomalies or groups of anomalies, which were inoperable, incompletely correctable or only managed with palliative care and classified as complex.…”

Section: Fetal Echocardiographic Examinationmentioning

confidence: 99%

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Prevalence and distribution of structural heart diseases in high and low risk pregnancies

Özbarlas¹,

Erdem²,

Küçükosmanoğlu³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Doğuştan kalp hastalıkları için yüksek ve düşük risk taşıyan gebelerde intrauterin kalp hastalığı sıklığını belirlemek ve karşılaştırmak. Yöntemler: Üniversitemiz Tıp Fakültesi Pediatrik Kardiyoloji Ünitesinde fetal ekokardiyografi yapılan 3782 gebenin kayıtları ve ekokardiyografi sonuçları retrospektif olarak değerlendirildi. Gruplar arasındaki değişkenler Ki-kare testi kullanılarak analiz edildi. Bulgular: Yüksek ve düşük riskli gruplardaki tüm fetüslerin 213'ünde (%5.6) yapısal kalp hastalığı bulundu. En sık patolojiler ventriküler septal defekt (%36.2) ve atriyoventriküler septal defekt (%14.1) idi. Yüksek riskli grupta doğuştan kalp hastalığı sıklığı %7.8 (169 fetüs) bulundu; %4.1'i kompleks, %2.3'ü önemli, %1.4'ü minör patolojiydi. Düşük riskli grupta bu oran %2.7 (44 fetüs) idi; %0.6'sı kompleks, %0.8'i önemli ve %1.3'ü minör patolojiydi. Bu grupta bazı nedenlerle başvuranlarda yapısal kalp hastalığı sıklığı yüksek bulundu; önceki gebelikte intrauterin fetal ölüm (%6.3), anormal birinci ve ikinci üç aylık dönem tarama testleri (%4.3) ve çoğul gebelik (%3.4). Fetal ekokardiyografik incelemenin duyarlılığı %86, özgül-lüğü %98 bulundu. Sonuç: Doğuştan kalp hastalığı sıklığı beklenildiği gibi yüksek riskli grupta daha yüksek bulundu. Düşük riskli grupta yer almalarına rağmen önceki gebelikte intrauterin fetal ölüm, anormal birinci ve ikinci üç aylık dönem tarama testleri ve çoğul gebelik nedeniyle başvuranlardaki kalp hastalığı sıklığı ile yüksek riskli gruptaki kalp hastalığı sıklığı arasında istatistiksel olarak anlamlı bir fark bulunmadı. Bu nedenle kardiyoloji kliniğinin bu konuda uzman kardiyoloğu ve ekipmanı yeterli ise yukarıdaki nedenlerle başvuran gebelere rutin fetal ekokardiyografik çalışma yapılmasını öneriyoruz. (Anadolu Kardiyol Derg 2011; 2: 125-30) Anahtar kelimeler: Doğuştan kalp hastalığı, fetal ekokardiyografi, yüksek riskli gebelik, düşük riskli gebelik ABSTRACT Objective: To establish and compare the frequency of intrauterine congenital heart defects in high-risk and low-risk pregnancies for congenital heart diseases. Methods: Records of 3782 patients who underwent fetal echocardiography at the Pediatric Cardiology Unit were reviewed for reasons of referral and results of echocardiography retrospectively. The categorical variables between the groups were analyzed using a Chi-square test. Results: Structural heart defects were found in 213 (5.6%) fetuses in both high and low risk groups. Most common defects were ventricular septal defect (36.2%) and atrioventricular septal defect (14.1%). Frequency of congenital heart diseases was 7.8% (169 fetuses) in high-risk group: 4.1% were complex, 2.3% significant and 1.4% were minor. In low-risk group, the frequency was 2.7% (44 fetuses): 0.6% were complex, 0.8% significant and 1.3% were minor. In this group, rates of congenital defects were high regarding particular reasons: intrauterine fetal death in previous pregnancy (6.3%), abnormal first or second trimester screening tests (4.3%), and multiple gestations (3.4%). The sensitivity and...

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Section: Discussionmentioning

confidence: 99%

Section: Fetal Echocardiographic Examinationmentioning

confidence: 99%

Prevalence and distribution of structural heart diseases in high and low risk pregnancies

Özbarlas¹,

Erdem²,

Küçükosmanoğlu³

et al. 2011

Anadolu Kardiyol Derg

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“…Como ejemplo, la tasa de detección de defectos cardíacos mayores se duplicó luego de la implementación de un Programa de capacitación de 2 años en un centro médico en el norte de Inglaterra (47,48).…”

Section: Impacto De Los Programas De Detección Antenatalunclassified

Diagnóstico prenatal de anomalías congénitas; una política ausente en Colombia

Cano

Adolfo²

2016

Rev. Med.

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ResumenObjetivos: Realizar un artículo de revisión sobre el impacto de los programas de tamizaje prenatal ecográfica de malformaciones congénitas.Determinar la existencia de una política gubernamental para la detección prenatal de estas en nuestro país y comparar las tasas de detección local con las reportadas internacionalmente. Materiales y métodos:Este es un artículo de revisión. Se realizó una búsqueda electrónica en PubMed, Hinari, Cochrane y portales de salud, se incluyeron artículos que cumpliendo los criterios de inclusión describían el uso de la ecografía antenatal para la detección de malformaciones congénitas así como los relacionados a las tasas de detección en Colombia y el mundo.Conclusiones: El implementar esquemas de diagnóstico antenatal ecográfico de alteraciones congénitas mejora las tasas de detección, en nuestro sistema público de salud estas no superan el 35 por ciento, estando por debajo de las reportadas internacionalmente. En Colombia, aunque existe una guía clínica propuesta por el ministerio de protección social, está no se ha implementado ni ejecutado por la mayoría de las diferentes instituciones prestadoras de salud.Palabras Clave: Anomalías congénitas, Ultrasonografía, Diagnóstico prenatal. Determine the existence of a government policy for prenatal detection in our country and compare the local detection rates with reported internationally. Materials and methods:This paper is a review article. A search was conducted in PubMed, Hinari, Cochrane and portals of health. Choosing articles who met the inclusion criteria and describes the use of antenatal ultrasography for the detection of congenital malformations; as well as those related to the detection rates in Colombia and the world.Conclusions: Implementing schemes sonographic diagnosis of congenital disorders antenatal improves detection rates, in our public health system, these do not exceed 35 percent, these are lower than those reported internationally.In Colombia there is a guide proposed by the ministry of social protection, but this is not implemented or executed by most different health institutions.

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“…As the teaching study from Hunter et al demonstrated, there is a danger that if support from paediatric cardiology is not ongoing then the initial efficacy of training may diminish. (Hunter et al, 2000) Telemedicine has the potential to facilitate earlier diagnosis of CHD by offering increased and quicker access to specialist opinion. Telemedicine may also support sonographers' education and training.…”

Section: The Clinical Imperativementioning

confidence: 99%