The outcome of fetal congenital heart disease.

Series reporting congenital heart disease detected in utero all indicate a different spectrum and severity of disease than is seen in postnatal series, with a tendency toward more severe disease with a poorer outcome. This is largely because of the manner in which cases are selected for fetal echocardiography. As most forms of heart disease occur in otherwise normal pregnancies with no high risk features, detection of these cases is dependent on the skill of the ultrasonographer performing general obstetric scanning. Although detection of even major malformations seen in the four chamber view, is still less than perfect, it is improving. In the future, it is expected that malformations will be detected in earlier pregnancy and examination will include evaluation of great artery structure. This will give more parents the option of termination of pregnancy in complex disease. Alternatively, in continuing pregnancies, the outcome for the affected neonate will be improved by ideal perinatal care.