Abstracts for the British Congenital Cardiac Association Annual Meeting: The Barbican, London, 24–25 November 2005: Poster Presentations: 8 Years of fetal echocardiography in high-risk mothers: The Birmingham Women’s Hospital experience

Abstract

Introduction: Congenital heart disease (CHD) affects 8 per 1000 live births and it is also responsible for 20% of neonatal deaths. Antenatal diagnosis of major CHD allows appropriate counselling and planning for delivery at a neonatal unit with appropriate intensive care and transport facilities. Birmingham Women’s Hospital provides a supra-regional specialist fetal echocardiography in high-risk mothers. Aim: To evaluate fetal echocardiography findings in high-risk mothers over an 8 year period. Method: We undertook a retrospective review of all pregnant women at high-risk of having a baby with congenital heart disease who underwent fetal echocardiography between 01/01/1997 and 31/12/2004 at Birmingham Women’s Hospital. Results: 3,963 mothers were referred for fetal echocardiography and a total of 5,568 fetal echocardiography examinations were carried out during this period. The main reasons for referral were: (i) previously affected child – 27% (ii) abnormal initial screening scan – 20.7% (iii) maternal cardiac condition – 9.5% (iv) infant of diabetic mothers – 8% and (v) increased fetal nuchal translucency – 3%. Seven hundred and twleve (17.9%) echocardiograms were reported as abnormal. The majority of the abnormalities were identified in mothers who had abnormal initial screening scan (62%). In addition, the echocardiogram was also abnormal in 9% of cases with increased fetal nuchal translucency and in 5.7% of infants of diabetic mothers. In those with previously affected child and maternal cardiac condition, the echocardiogram was abnormal in 2.5% and 2.6% respectively. Conclusion: Abnormal initial screening scans and increased nuchal translucency had the highest yield in identifying CHD in high-risk mothers. Infant of diabetic mothers also have an increased risk warranting fetal cardiac screening for CHD. Normal fetal echocardiogram provides reassurance for the remainder of parents.