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

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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
Volume31
Issue number12
DOIs
Publication statusPublished - 2011
Externally publishedYes

Cite this

@article{7697ba0f81d048eea113be0f71a022e6,
title = "Audit of 10 years of referrals for fetal echocardiography",
abstract = "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. {\circledC} 2011 John Wiley & Sons, Ltd.",
author = "Clur, {S. A. B.} and {van Brussel}, {P. M.} and Mathijssen, {I. B.} and E. Pajkrt and J. Ottenkamp and Bilardo, {C. M.}",
year = "2011",
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language = "English",
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pages = "1134--1140",
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Audit of 10 years of referrals for fetal echocardiography. / Clur, S. A. B.; van Brussel, P. M.; Mathijssen, I. B.; Pajkrt, E.; Ottenkamp, J.; Bilardo, C. M.

In: Prenatal Diagnosis, Vol. 31, No. 12, 2011, p. 1134-1140.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Audit of 10 years of referrals for fetal echocardiography

AU - Clur, S. A. B.

AU - van Brussel, P. M.

AU - Mathijssen, I. B.

AU - Pajkrt, E.

AU - Ottenkamp, J.

AU - Bilardo, C. M.

PY - 2011

Y1 - 2011

N2 - 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.

AB - 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.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/21915886

U2 - 10.1002/pd.2847

DO - 10.1002/pd.2847

M3 - Article

VL - 31

SP - 1134

EP - 1140

JO - Prenatal Diagnosis

JF - Prenatal Diagnosis

SN - 0197-3851

IS - 12

ER -