Priya Sekar1, Haleh C Heydarian1, James F Cnota1, Lisa K Hornberger2, Erik C Michelfelder1. 1. 1Department of Pediatrics,Cincinnati Children's Hospital Medical Center,Division of Pediatric Cardiology,The Heart Institute,Cincinnati,Ohio,United States of America. 2. 3Departments of Pediatrics,Division of Pediatric Cardiology and Obstetrics and Gynecology,Fetal & Neonatal Cardiology Program,University of Alberta,Edmonton,Alberta,Canada.
Abstract
OBJECTIVES: Diagnostic ultrasound is widespread in obstetric practice, yet many babies with major congenital heart disease remain undiagnosed. Factors affecting prenatal diagnosis of major congenital heart disease are not well understood. This study aims to document prenatal detection rates for major congenital heart disease in the Greater Cincinnati area, and identify factors associated with lack of prenatal diagnosis. METHODS: All living infants diagnosed with major congenital heart disease by 4 months of age at our centre were prospectively identified. Prenatal care data were obtained by parent interview. Neonatal records were reviewed for postnatal data. Obstetricians were contacted for diagnostic ultrasound data. RESULTS: A total of 100 infants met the inclusion criteria. In all, 95 infants were analysed, of whom 94 were offered diagnostic ultrasound. In all, 41 had a prenatal diagnosis of major congenital heart disease. The rate of prenatal detection varied by cardiac lesion, with aortic arch abnormalities, semilunar valve abnormalities, and venous anomalies going undetected in this sample. Among subjects without prenatal detection, the highest proportion consisted of those having Level 1 diagnostic ultrasound only (66%). Prenatal detection was not significantly influenced by maternal race, education level, income, or insurance type. CONCLUSIONS: Despite nearly universal diagnostic ultrasound, detection rates of major congenital heart disease remain low in southwest Ohio. An educational outreach programme including outflow tract sweeps for community-level obstetrical personnel may improve detection rates.
OBJECTIVES: Diagnostic ultrasound is widespread in obstetric practice, yet many babies with major congenital heart disease remain undiagnosed. Factors affecting prenatal diagnosis of major congenital heart disease are not well understood. This study aims to document prenatal detection rates for major congenital heart disease in the Greater Cincinnati area, and identify factors associated with lack of prenatal diagnosis. METHODS: All living infants diagnosed with major congenital heart disease by 4 months of age at our centre were prospectively identified. Prenatal care data were obtained by parent interview. Neonatal records were reviewed for postnatal data. Obstetricians were contacted for diagnostic ultrasound data. RESULTS: A total of 100 infants met the inclusion criteria. In all, 95 infants were analysed, of whom 94 were offered diagnostic ultrasound. In all, 41 had a prenatal diagnosis of major congenital heart disease. The rate of prenatal detection varied by cardiac lesion, with aortic arch abnormalities, semilunar valve abnormalities, and venous anomalies going undetected in this sample. Among subjects without prenatal detection, the highest proportion consisted of those having Level 1 diagnostic ultrasound only (66%). Prenatal detection was not significantly influenced by maternal race, education level, income, or insurance type. CONCLUSIONS: Despite nearly universal diagnostic ultrasound, detection rates of major congenital heart disease remain low in southwest Ohio. An educational outreach programme including outflow tract sweeps for community-level obstetrical personnel may improve detection rates.
Authors: Nelangi M Pinto; Kevin A Henry; William A Grobman; Amen Ness; Stephen Miller; Sarah Ellestad; Nina Gotteiner; Theresa Tacy; Guo Wei; L LuAnn Minich; Anita Y Kinney Journal: J Ultrasound Med Date: 2019-12-24 Impact factor: 2.153
Authors: Michael D Quartermain; Sara K Pasquali; Kevin D Hill; David J Goldberg; James C Huhta; Jeffrey P Jacobs; Marshall L Jacobs; Sunghee Kim; Ross M Ungerleider Journal: Pediatrics Date: 2015-08 Impact factor: 7.124
Authors: Anita Krishnan; Marni B Jacobs; Shaine A Morris; Shabnam Peyvandi; Aarti H Bhat; Anjali Chelliah; Joanne S Chiu; Bettina F Cuneo; Grace Freire; Lisa K Hornberger; Lisa Howley; Nazia Husain; Catherine Ikemba; Ann Kavanaugh-McHugh; Shelby Kutty; Caroline Lee; Keila N Lopez; Angela McBrien; Erik C Michelfelder; Nelangi M Pinto; Rachel Schwartz; Kenan W D Stern; Carolyn Taylor; Varsha Thakur; Wayne Tworetzky; Carol Wittlieb-Weber; Kris Woldu; Mary T Donofrio Journal: Circulation Date: 2021-05-17 Impact factor: 39.918