The Utility of Fetal Echocardiography After an Unremarkable Anatomy Scan

Friedman, Alexander M.; Phoon, Colin K.L.; Fishman, Shira; Seubert, David; Timor‐Tritsch, I. E.; Schwartz, Nadav

doi:10.1097/aog.0b013e31822e1264

Cited by 16 publications

(31 citation statements)

References 28 publications

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“…The overall higher rate of diagnosis by the pediatric cardiologists might be explained by the fact that, in most cases, antenatal pediatric fetal echocardiogram was performed at about 22 weeks or later while the initial MFM study was performed at 16–21 weeks for the great majority of cases. One would expect that the optimal technical study terms in the early neonatal period would result in better diagnosis when performed by experienced and skilled pediatric cardiologist as has been previously reported [8, 9, 11, 12]. This is further supported by the two cases in which both the MFM physicians and the pediatric cardiologists failed to correctly identify major cardiac abnormalities in the same two fetuses.…”

Section: Discussionsupporting

confidence: 59%

“…Diagnosis agreement in these studies ranged 38% to 100%. Some of the authors concluded that fetal echocardiography by pediatric cardiologists adds little to the care of women with no suspected heart disease on a detailed anatomic survey by OBGYN/MFM physician [9, 10], while others concluded that improved accuracy in diagnosis can be achieved through a pediatric cardiologist with special skills in fetal echocardiography working collaboratively with obstetric sonographers and sonologists to optimize the details of diagnosis [8, 9, 11, 12]. Naturally, the latter studies had lower level of diagnostic accuracy and agreement in comparison to the former studies.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal Detection of Cardiac Anomalies in Fetuses with Single Umbilical Artery: Diagnostic Accuracy Comparison of Maternal-Fetal-Medicine and Pediatric Cardiologist

Tasha¹,

Brook

Frasure

et al. 2014

Journal of Pregnancy

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Aim. To determine agreement of cardiac anomalies between maternal fetal medicine (MFM) physicians and pediatric cardiologists (PC) in fetuses with single umbilical artery (SUA). Methods. A retrospective review of all fetuses with SUA between 1999 and 2008. Subjects were studied by MFM and PC, delivered at our institution, and had confirmation of SUA and cardiac anomaly by antenatal and neonatal PC follow-up. Subjects were divided into four groups: isolated SUA, SUA and isolated cardiac anomaly, SUA and multiple anomalies without heart anomalies, and SUA and multiple malformations including cardiac anomaly. Results. 39,942 cases were studied between 1999 and 2008. In 376 of 39,942 cases (0.94%), SUA was diagnosed. Only 182 (48.4%) met inclusion criteria. Cardiac anomalies were found in 21% (38/182). Agreement between MFM physicians and PC in all groups combined was 94% (171/182) (95% CI [89.2, 96.8]). MFM physicians overdiagnosed cardiac anomalies in 4.4% (8/182). MFM physicians and PC failed to antenatally diagnose cardiac anomaly in the same two cases. Conclusions. Good agreement was noted between MFM physicians and PC in our institution. Studies performed antenatally by MFM physicians and PC are less likely to uncover the entire spectrum of cardiac abnormalities and thus neonatal follow-up is suggested.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Prenatal Detection of Cardiac Anomalies in Fetuses with Single Umbilical Artery: Diagnostic Accuracy Comparison of Maternal-Fetal-Medicine and Pediatric Cardiologist

Tasha¹,

Brook

Frasure

et al. 2014

Journal of Pregnancy

View full text Add to dashboard Cite

show abstract

“…The fetal echocardiographic examinations were performed by an experienced fetal medicine consultant or by a fetal cardiologist. Recent reports have shown that fetal echocardiography may be of limited benefit after normal anatomy scan results have been obtained at an institution where a high volume of sonographic examinations are performed or where the examinations are read by maternal‐fetal medicine specialists …”

Section: Discussionmentioning

confidence: 99%

Isolated Single Umbilical Artery and Fetal Echocardiography: A 25‐Year Experience at a Tertiary Care City Hospital

Gurram

Figueroa

Sipusic

et al. 2017

J of Ultrasound Medicine

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“…Prior to the universal recommendation of implementing views of the outflow tracts, some advocated for universal fetal echocardiography screening due it its high sensitivity for the detection of CHD . However, since the inclusion of the outflow tracts into the detailed ultrasound, some question the role of screening fetal echocardiogram in the presence of a normal cardiac exam on a detailed ultrasound . Although fetal echocardiography improves detection rates over routine anatomical screening, it is technically demanding and expensive .…”

Section: Introductionmentioning

confidence: 99%

The added value of screening fetal echocardiography after normal cardiac views on a detailed ultrasound

et al. 2019

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Objective Evaluate fetal echocardiography's ability to detect critical (lesions requiring immediate neonatal intensive care) congenital heart disease (CHD) after normal anatomic cardiac views on detailed ultrasound. Methods Singletons with both a detailed ultrasound at 18 + 0 to 22 + 6 weeks and echocardiogram performed at least 14 days later and at 20 + 0 to 24 + 6 weeks. Cases with cardiac pathology on detailed ultrasound were excluded. Different combinations of cardiac views were described: Basic (four‐chamber, outflow tracts), Expanded (plus three‐vessel view), and Complete (plus ductal/aortic arches). “Normal” was defined on either 2D gray scale or color Doppler. Primary outcome was rates of critical CHD missed on ultrasound but seen on fetal echocardiogram. Results One thousand two hundred twenty‐three women had normal Basic cardiac views. One thousand one hundred ninety (97.3%) were confirmed normal on echocardiogram. Twenty‐one (1.71%) total CHDs were missed, and three were critical (0.25%; 95% CI, 0.03%‐0.53%). Of the 1,223 women, 763 had Complete views. Ten (1.31%) total CHDs were missed and one (0.13%; 95% CI, 0.13%‐0.36%) was confirmed critical. Conclusion Fetal echocardiography can increase CHD detection despite normal cardiac anatomy on detailed ultrasound; however, CHDs missed are rarely critical. Approximately 750 fetal echocardiograms need to be performed to detect one critical CHD with Complete normal cardiac views on detailed ultrasound.

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The Utility of Fetal Echocardiography After an Unremarkable Anatomy Scan

Abstract: III.

Cited by 16 publications

References 28 publications

Prenatal Detection of Cardiac Anomalies in Fetuses with Single Umbilical Artery: Diagnostic Accuracy Comparison of Maternal-Fetal-Medicine and Pediatric Cardiologist

Prenatal Detection of Cardiac Anomalies in Fetuses with Single Umbilical Artery: Diagnostic Accuracy Comparison of Maternal-Fetal-Medicine and Pediatric Cardiologist

Isolated Single Umbilical Artery and Fetal Echocardiography: A 25‐Year Experience at a Tertiary Care City Hospital

The added value of screening fetal echocardiography after normal cardiac views on a detailed ultrasound

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