Abstract
Background: Fetal Echocardiography is becoming an important tool for the detection of
CHD but results can be unpredictable, depending on various factors like expertise, position
of the baby and referral indications. Various factors are associated with detection of CHD
which need further evaluation.
The present study was undertaken to study the referral pattern for Fetal Echocardiography
(FE) at a tertiary Pediatric Cardiac Centre and further to identify the various risk factors
associated with Congenital heart defect.
Results: The study was conducted on 200 consecutive pregnant women who were referred
for fetal echocardiography at Pediatric Cardiac Unit of the hospital. The mean maternal age
and the mean gestational age were 26.85 ± 4.6 years and 30.36 ± 5.14 weeks at the time of
fetal screening. On evaluating the various referral indications, gestational diabetes mellitus
was found in 55% of the study subjects, but CHD was detected in 3.6% of their fetuses.
Hypothyroidism was the second commonest indication (16.5%) among the referrals and 3%
of their foetuses were found to have CHD. The indication that accounted for the maximum
number of CHD (50%) was cardiac anomaly detected on ultrasonography, followed
by single umbilical artery, in which 33.3% of CHD was detected. CHD was however
significantly associated only with the referral indications of cardiac anomaly on USG (p
value < 0.001) and single umbilical artery (p value = 0.033). The association of the other
referral indications of the subjects was not found to be significant.
Conclusion: Majority of women referred late for the fetal echocardiography screening.
Extracardiac anomaly during second trimester scan warrants immediate fetal cardiac
evaluation.
Keywords
fetal echocardiography, congenital heart defect(CHD), diabetes, extracardiac anomalies