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Prenatal detection of fetal heart disease at Jordan University Hospital: early experience in a developing country

Published online by Cambridge University Press:  09 July 2019

Laila Tutunji ,
Fida Thekrallah ,
Asma Basha ,
Bushra Awaysheh ,
Shorouq Amer ,
Lina Khatib ,
Lubna Hamdan ,
Nisreen Saber ,
Asma Mustafa  and
Rama Jadallah
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Laila Tutunji
Affiliation:
Section of Cardiology, Department of Pediatrics, Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan
Fida Thekrallah
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Jordan, Amman-Jordan, Amman, 11942, Jordan
Asma Basha
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Jordan, Amman-Jordan, Amman, 11942, Jordan
Bushra Awaysheh
Affiliation:
Department of Pediatrics, Jordan University Hospital, Amman-Jordan, Amman, 11942, Jordan
Shorouq Amer
Affiliation:
Department of Pediatrics, Jordan University Hospital, Amman-Jordan, Amman, 11942, Jordan
Lina Khatib
Affiliation:
Department of Pediatrics, Faculty of Medicine, The University of Jordan, Amman-Jordan, Amman, 11942, Jordan
Lubna Hamdan
Affiliation:
Department of Pediatrics, Faculty of Medicine, The University of Jordan, Amman-Jordan, Amman, 11942, Jordan
Nisreen Saber
Affiliation:
Department of Pediatrics, Jordan University Hospital, Amman-Jordan, Amman, 11942, Jordan
Asma Mustafa
Affiliation:
Department of Pediatrics, Jordan University Hospital, Amman-Jordan, Amman, 11942, Jordan
Rama Jadallah
Affiliation:
Department of Pediatrics, Jordan University Hospital, Amman-Jordan, Amman, 11942, Jordan
Fawaz Kazaleh
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Jordan, Amman-Jordan, Amman, 11942, Jordan
Manar Al-Lawama
Affiliation:
Section of Neonatology, Department of Pediatrics, Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan
Eman Badran
Affiliation:
Section of Neonatology, Department of Pediatrics, Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan
Iyad AL-Ammouri*
Affiliation:
Section of Cardiology, Department of Pediatrics, Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan
*
Author for Correspondence: Iyad Al-Ammouri, MD, FAAP, FACC, Section of Pediatric Cardiology, The University of Jordan, Faculty of Medicine, Amman, 11942, Jordan. Tel: 0096265353666 ext. 2767; Fax: ++96265300820; E-mail: [email protected]
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Abstract

Objective:

To report on the first 5 years of establishment of fetal echocardiographic services at the Jordan University Hospital with emphasis on diagnosis and outcome.

Methods:

A retrospective chart review was conducted on all fetal echocardiographic studies performed between January 2011 and December 2015. Data collected included maternal demographics, referral indications, fetal cardiac diagnosis, correlation to post-natal diagnosis, outcome of pregnancy including pre-mature delivery and perinatal mortality. Basic statistical analysis was performed including demographic analysis, and calculation of fetal echocardiographic sensitivity and specificity.

Results:

A total of 208 fetuses underwent fetal echocardiographic evaluation at a mean gestational age of 26.5 (±5) weeks. The most common referral indication was a suspicion of CHD during the obstetric ultrasound (44.2%), followed by cardiac dysfunction (18.2%), and a family history of CHD (14.9%). Fetal echocardiography showed CHD in 71 fetuses (34%), heart failure in 26 (12.5%), arrhythmia in 9 (4.3%), and intracardiac masses in 2. In the remaining 100 fetuses (48%), fetal echocardiography showed normal evaluation. For detecting CHD, fetal echocardiography had a sensitivity and specificity of 91.7% and 95.4%, respectively. Perinatal mortality including termination of pregnancy, intrauterine fetal death, and neonatal mortality was highest in heart failure (77%), and was 41% for CHD.

Conclusion:

The fetal cardiac diagnostic services at the Jordan University Hospital have encouraging initial results with a relatively high sensitivity and specificity. The services further positively impacted the quality of counselling offered and facilitated pre- and post-natal management.

Keywords

CHDfetal diagnosishydrops fetalisfetal arrhythmiafetal echocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 8 , August 2019 , pp. 1072 - 1077
Copyright
© Cambridge University Press 2019 

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