Trends and Outcomes After Prenatal Diagnosis of Congenital Cardiac Defects: Experience of a Dedicated Fetal Medicine Centre from South India

Abstract

The primary objective of the study was to present a 5-year data on the outcomes after prenatal diagnosis of CHD. This is a retrospective descriptive study, conducted in the fetal medicine unit of an academic tertiary care referral centre in South India. The details of all cases with a prenatal diagnosis of fetal cardiac lesions from January 2012 through December 2016 were collected. All cases were systematically analyzed for type of lesion, associated malformations, chromosomal abnormalities, prognosis of the lesion, the decision taken by the couples and the information regarding post natal outcome, wherever available. Prenatally diagnosed fetal cardiac lesions were identified in 310 cases. In 220 (76.1%) cases, the couple opted for termination of pregnancy. In this group, 52% of them had an isolated cardiac defect with good prognosis. In the rest of the 69 cases who decided to continue, 7 cases had an IUD. In the 62 cases that culminated in a live birth, 46 cases opted for postnatal cardiac care. Corrective surgery was attempted in 18 neonates with 2 resulting in neonatal death. Prenatal diagnosis of isolated CHD provides an opportunity for an improved immediate neonatal outcome. A thorough evaluation for extracardiac and genetic abnormality will facilitate better utilization of health care resources by triaging patients with isolated CHD having good prognosis for targeted postnatal care. Also, antenatal pediatric cardiology counselling will enable the couple to make decisions regarding postnatal management options.