Abnormal Cardiac Findings in Prenatal Sonographic Examination: an Important Indication for Fetal Echocardiography?

Aim: The present study was conducted to evaluate the most common indications for fetal echocardiography in a tertiary-care fetal echocardiography practice. Methods: A retrospective analysis (July 2005 to July 2006) of all pregnant women referred by obstetricians or fetomaternal sonographers to a pediatric cardiology unit for fetal echocardiography over a 1-year period was performed .The study was performed at a large university hospital in the western region of Saudi Arabia. The primary indications for referral for fetal echocardiography were obtained from the obstetric referral forms. Outcome data were extracted from the fetal echocardiograms, postnatal echocardiograms and/or patient medical records. Results: Sixty pregnant women had been referred for fetal echocardiography. The most common primary indication for referral had been abnormal cardiac findings on the prenatal sonographic examination, which had been present in 21 (35%) of the 60 cases. In 19 (90%) of those 21 cases, congenital heart disease (CHD) had been confirmed prenatally and postnatally. Among the 39 patients who had had normal cardiac findings on prenatal sonography but had been referred for fetal echocardiography owing to other primary indications, CHD had been confirmed in only 8 cases (20%). All 19 of 21 patients in whom fetal echocardiography had shown CHD had completed their pregnancies. Conclusions. Our study shows that a common primary indication for fetal echocardiography during prenatal sonographic examination is an abnormal cardiac finding, which is more useful for identifying congenital heart disease than are other risk factors. Detailed routine fetal echocardiography during routine prenatal ultrasound may result in further investigation and treatment.