Clinical experience with fetal echocardiography
J. J. Wheller, R. Reiss and H. D. Allen
Division of Pediatric Cardiology, Ohio State University, Columbus.
Current ultrasound technology allows for accurate evaluation of the fetal
heart. To evaluate the importance and accuracy of the routine clinical use
of fetal echocardiography at our center, a consecutive series of 338 fetal
cardiac studies of 323 patients was reviewed. Average gestational age was
24 weeks (range, 17 to 39 weeks). Forty-seven (15%) patients with abnormal
conditions were detected. The most common indication for fetal cardiac scan
was a family history of congenital heart disease (28%). Other indications
were maternal diabetes mellitus (25%), fetal dysrhythmia (14%), other major
defect (10%), drug exposure (10%), and obstetrician suspicion of fetal
congenital heart disease on routine scan (10%). The highest yield of
significant abnormal findings was among those referred for dysrhythmia
(31%) and obstetrician suspicion of congenital heart disease (29%). Five
fetuses with sustained supraventricular tachycardia and hydrops were
successfully treated. The combination of fetal bradycardia and structural
heart disease was the most ominous finding. Fifteen (4.6%) patients had
clear changes in management based on the fetal echocardiogram. Our
experience suggests that the routine use of fetal echocardiography is
accurate and an important part of the overall management of the pregnancy
considered at risk for producing an infant with congenital heart disease.
