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. 2021 Jun;71(3):277-284.
doi: 10.1007/s13224-020-01424-3. Epub 2021 Mar 3.

Efficacy of Antenatal Ultrasound Examination in Diagnosis of Congenital Cardiac Anomalies in an Unselected Population: Retrospective Study from a Tertiary Centre

N D Varunashree  1 , Ravi Shankar  2 , Preethi Navaneethan  1 , Manish Kumar  3 , Santosh Joseph Benjamin  1 , Smitha Elizabeth Jacob  1 , Bijesh Yadav  4 , Swati Rathore  1
Affiliations

Efficacy of Antenatal Ultrasound Examination in Diagnosis of Congenital Cardiac Anomalies in an Unselected Population: Retrospective Study from a Tertiary Centre

N D Varunashree et al. J Obstet Gynaecol India. 2021 Jun.

Abstract

Background: In Low- and Middle-Income Countries like India, where the services and surgical care for Congenital Heart Disease (CHD) are available only in selected centres with geographical variations, it is important to detect Heart defects early and give the parents an opportunity to plan ahead for seeking appropriate care at the earliest. Several developments in recent years such as improvement of quality of ultrasound machines, sonographer's experience, skills and better description of cardiac views have contributed to improve detection rate.

Methods: A retrospective study was done between March 2016 and December 2019, and showed ultrasound evidence of CHD was included.

Results: The total number of morphology scans done during study period was 50,435. The number of congenital anomalies detected was 1482, out of which CHD was detected in 334 (22.5%). Outcome of 50 pregnancies were not available while the rest (284) were available for follow up in post-natal period. There were 51 cases of CHD, missed on routine antenatal morphological screening, which were diagnosed in the post-natal period. There were 18 cases of over-diagnosed CHD on antenatal scan, but were found to have normal echo findings after birth.

Conclusion: A systematic approach is crucial for practitioner to determine the patterns of associated defects. Use of step wise strategy helps in determining the correct diagnosis of isolated cardiac defect, associated with other system or a part of syndrome. Systematic audit of morphological scans could play an important role in improving the diagnostic accuracy, which in turn will lead to early detection.

Keywords: Cardiac defects; Missed diagnosis; Morphology scan; Perinatal outcome.

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Conflict of interest statement

Conflict of interestNil, Varunashree ND (VND), Ravi Shankar (RS), Manish Kumar (MK), Preethi Navaneethan, (PN), Santosh Benjamin (SB), Smitha Elizabeth Jacob (SMJ), Bijesh Yadav (BY) and Swati Rathore (SR) declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram showing recruitment of participants after exclusion at different levels
Fig. 2
Fig. 2
Flow chart summarizing management plan for CHD after antenatal ultrasonography
See this image and copyright information in PMC

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