Prenatal detection rates for congenital heart disease using abnormal obstetrical screening ultrasound alone as indication for fetal echocardiography.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2024-06-01 Epub Date: 2024-03-15 DOI:10.1002/pd.6544

Sanjay Vepa, Mubarika Alavi, Weilu Wu, Julie Schmittdiel, Lisa J Herrinton, Kavin Desai

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引用次数: 0

Abstract

Objective: To determine the live born prenatal detection rate of significant congenital heart disease (CHD) in a large, integrated, multi-center community-based health system using a strategy of referral only of patients with significant cardiac abnormalities on obstetrical screening ultrasound for fetal echocardiography. Detection rates were assessed for screening in both radiology and maternal fetal medicine (MFM). The impact on fetal echocardiography utilization was also assessed.

Methods: This was a retrospective cohort study using an electronic health record, outside claims databases and chart review to determine all live births between 2016 and 2020 with postnatally confirmed sCHD that were prenatally detectable and resulted in cardiac surgery, intervention, or death within 1 year.

Results: There were 214,486 pregnancies resulting in live births. Prenatally detectable significant CHD was confirmed in 294 infants. Of those 183 were detected for an overall live-born detection rate of 62%. Detection rates in MFM were 75% and in radiology were 52%. The number of fetal echocardiograms needed to detect (NND) sCHD was 7.

Conclusions: A focus on quality and standardization of obstetrical screening ultrasound with referral to fetal echocardiography for cardiac abnormalities alone achieves benchmark targets for live-born detection of significant CHD requiring fewer fetal echocardiograms.

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仅以异常产科超声筛查作为胎儿超声心动图检查指征的先天性心脏病产前检出率。

目的在一个大型、综合、多中心的社区医疗系统中，采用仅将产科超声筛查中发现明显心脏畸形的患者转诊至胎儿超声心动图检查的策略，以确定重大先天性心脏病（CHD）的活产儿产前检出率。对放射科和母体胎儿医学科（MFM）筛查的检出率进行了评估。还评估了对胎儿超声心动图利用率的影响：这是一项回顾性队列研究，使用电子健康记录、外部索赔数据库和病历审查来确定 2016 年至 2020 年期间所有产后确诊为 sCHD 的活产婴儿，这些婴儿在产前可检测到，并在 1 年内导致心脏手术、干预或死亡：结果：共有 214,486 例妊娠导致活产。294名婴儿在产前被证实患有可检测到的严重先天性心脏病。其中 183 名婴儿被检出，活产婴儿总检出率为 62%。经产前超声心动图检查的检出率为 75%，放射科检查的检出率为 52%。检测（NND）sCHD 所需的胎儿超声心动图次数为 7.结论：结论：注重产科超声筛查的质量和标准化，仅在发现心脏异常时转诊至胎儿超声心动图检查，就能达到活产检出重大先天性心脏病的基准目标，从而减少胎儿超声心动图检查的次数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling