Prenatal Diagnosis of Congenital Heart Disease in a Developing Country-A Cross-Sectional Study.

Abstract

Objective: Prenatal detection of congenital heart disease (CHD) remains suboptimal in resource-limited settings. We quantified prenatal CHD detection, fetal echocardiography utilization, and predictors of counseling for fetal echocardiography in future pregnancies.

Method: We surveyed parents of children with CHD, capturing key sociodemographics, obstetric history, prenatal screening, use of fetal echocardiography, and future counseling. We compared prenatal versus postnatal diagnoses and used multivariable logistic regression to identify counseling predictors.

Results: Among 362 families, only 48 children (13.3%) were diagnosed prenatally, despite nearly universal obstetric follow-up (99.7%) and moderate prenatal ultrasound screening (59.4%). Prenatal ultrasound screening was more frequent among prenatally diagnosed cases (97.9% vs. 53.5%; p < 0.001). Fetal echocardiography was more common when extracardiac malformations were suspected and in moderate-to-complex CHD (p < 0.001). Only 113/362 (31.2%) of families reported receiving counseling for future pregnancies. In multivariable analysis, greater CHD complexity was independently associated with counseling (OR 3.21; p < 0.001), whereas family history of CHD was not (p = 0.91).

Conclusions: Prenatal CHD detection was uncommon and driven by screening practices. Counseling regarding fetal echocardiography was inconsistently delivered and concentrated on complex CHD. These findings highlight gaps in referral and counseling, supporting the need for stronger integration between obstetric and pediatric cardiology services.