Early detection of congenital heart disease in prenatal life.

The anatomy of the fetal heart can be well seen by real-time cross sectional ultrasonography between 16 weeks' gestation and term. Many major structural abnormalities can be excluded in early pregnancy even if only one section of the fetal heart is studied. We have accurately predicted structural cardiac malformation in nine cases in the mid-trimester of pregnancy. Five pregnancies were interrupted for extracardiac abnormalities. In two cases of severe cardiac abnormality termination of pregnancy was chosen by the parents. In the remaining pregnancies where an abnormality was predicted delivery took place in a centre equipped for immediate care of an affected infant. This gave the infant the optimum chance of survival.