Fetal Echocardiography Indications: A Single- Center Experience

Congenital heart disease (CHD) is the most common lethal congenital anomaly. Early diagnosis of CHD by fetal echocardiography based on maternal and fetal indications is important and lifesaving. The aim of study was to assess the referral aspects of pregnant women to pediatric cardiologist.

This was a retrospective cross-sectional study on 250 documents of referred pregnant women, which was conducted in Imam Reza hospital (Mashhad city, Iran) from 2012 to 2017. Relevant factors of referral to pediatric cardiologist were assessed in an unselected population of pregnant women, mostly based on guideline indications. Data were analyzed using SPSS software version 16.0.

From 250 fetuses 59.8% were male. The most common reasons of referral were abnormal ultrasonography and family history of CHD with 83% and 28.8 %, respectively, which were referred mostly by gynecologist (53.7%). Fetuses were mostly singleton (98. 8%). Five and six percent had associated extra-cardiac anomalies, mostly central nervous system and renal disorders. The mean age of referred pregnant women was 31.5+5.14 years. The mean age of gestation was 24.5+ 6.09 weeks. Seventy-one cases (28.4 %) have similar history in prior children.

Timely referral to pediatric cardiologist as an extraordinary benefit for pregnant women and also ongoing follow- up for the baby is requires an organized observation. Assessment and comparison with universal guidelines reveals our shortcomings. More than half of referred cases were identified too late in time and the whole indications were not done accurately