Prenatal detection of critical cardiac outflow tract anomalies remains suboptimal despite revised obstetrical imaging guidelines

• DOI: 10.1111/chd.12648
• Publication Date: 2018-07-19T08:48:46Z
• Authors: Heather Y. Sun; James A. Proudfoot; Rachel T. McCandless
• Keywords: Ventricular outflow tract

Background Fetal echocardiography can accurately diagnose critical congenital heart disease prenatally, but relies on referrals from abnormalities identified routine obstetrical ultrasounds. Critical that is frequently missed due to inadequate outflow tract imaging includes anomalies such as truncus arteriosus, double outlet right ventricle, transposition of the great arteries, tetralogy Fallot, pulmonary stenosis, and aortic stenosis. Objective This study evaluated prenatal detection rate in a single urban pediatric hospital before after "AIUM Practice Guideline for Performance Obstetric Ultrasound Examinations," which incorporated imaging. Design Infants with who required cardiac catheterization and/or surgical procedure(s) first 3 months life were retrospectively identified. two time periods; pre-guidelines June 2010 May 2013 post-guidelines January 2015 2016. 2013-December 2014 was excluded theoretical period necessary practices implement revised guidelines. Results Overall, diagnosis occurred 55% infants anomalies; three most common defects, 53% D-transposition 63% 80% ventricle patients. Pre-guidelines, 52% (52 102) requiring early intervention. Post-guidelines, 61% (33 54) infants, not significantly different than (P = .31). Conclusions Despite guidelines highlighting importance imaging, these types remain low. Education sonographers practitioners perform fetal anatomic screening vital increase anomalies.