Prenatal screening for congenital heart disease.

TLDR

Routine fetal ultrasound is standard in most British obstetric units, and severe cardiac abnormalities visible in the four‑chamber view occur in about two per 1,000 pregnancies. A simple, systematic method for evaluating the fetal four‑chamber view was devised and incorporated into routine obstetric screening, with the Guy9s Hospital pediatric cardiology department serving as a referral centre for fetal echocardiography over six years. As teaching spread, more cases were referred after obstetricians suspected abnormalities on the four‑chamber view, and currently 80 % of detected abnormalities are referred for this reason. Further extension and organisation of teaching might result in most severe cardiac malformations being detected in early prenatal life.

Abstract

Routine ultrasound examination of the fetus is already established in most obstetric units in Britain. A simple method was devised to evaluate one section of the fetal heart systematically. Examination of this section, the four chamber view, may readily be incorporated into routine obstetric screening. Severe cardiac abnormalities detectable in this view occur in two per 1000 pregnancies. For six years the department of paediatric cardiology at Guy9s Hospital, London, served as a referral centre for fetal echocardiography. As teaching became more widespread an increasing proportion of cases of cardiac anomaly were referred because the obstetrician suspected abnormality on examination of the four chamber view. Currently 80% of detected abnormalities are referred for this reason. Further extension and organisation of teaching might result in most severe cardiac malformations being detected in early prenatal life.