Audit of 10 years of referrals for fetal echocardiography

S. A. B. Clur, P. M. van Brussel, I. B. Mathijssen, E. Pajkrt, J. Ottenkamp, C. M. Bilardo

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Objectives: To evaluate trends over time, indications, diagnoses, noncardiac defects and outcome of fetuses referred for tertiary level echocardiography. Methods: Retrospective study of fetal echocardiograms performed between April 1999 and 2009. Results: Of the 623 fetuses included, 301 (48%) had cardiac pathology. Congenital heart defects (CHDs) were found in 243/301 (81%), mostly in the severe spectrum. Of the fetuses with CHDs, 26% (63/243) had chromosomal anomalies. The chromosomally normal fetuses with CHDs had a mortality rate of 43% (77/180) and 23% (41/180) had extra-cardiac anomalies. The termination of pregnancy (TOP) rate for all cardiac pathology was 24.9% (75/301) and for CHDs 29.6% (72/243). The TOP rates for CHDs diagnosed before 19 and 24weeks gestation were 61% (28/46) and 44% (68/155), respectively. An increase in referrals followed the introduction of a national screening program, (nuchal translucency (NT) and routine structural ultrasound screening). The main referral indication was an increased NT (>95th percentile; 32% of cases). CHDs were found in 81/239 (34%) fetuses with an increased NT. Conclusions: Referral indications for fetal echocardiography were appropriate (almost 50% had cardiac pathology). The mortality was high. Fetal outcome and TOP decisions correlated with CHD severity and presence of noncardiac defects. An increased NT is a strong marker for CHDs. © 2011 John Wiley & Sons, Ltd.
Original languageEnglish
Pages (from-to)1134-1140
JournalPrenatal Diagnosis
Issue number12
Publication statusPublished - 2011
Externally publishedYes

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