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CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2024; 11(02): 100-106
DOI: 10.1055/s-0044-1788637
Original Article

Antenatal Screening for Congenital Heart Disease: A Single Center 11-Year Study of the Incidence, Antenatal Detection Rate, and Outcomes of Fetal Cardiac Anomalies

Eilidh Clark 
1   Department of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, Scotland
,
Nithiya Palaniappan
2   Department of Obstetrics and Gynaecology, Victoria Hospital Kirkcaldy, Kirkcaldy, United Kingdom
,
Isobel Clegg
3   Department of Obstetrics and Gynaecology, Fetal Medicine Midwife, Victoria Hospital Kirkcaldy, NHS Fife, Kirkcaldy, United Kingdom
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Abstract

Objectives This article describes the incidence, detection rate, and birth outcomes of congenital heart disease (CHD) within a single center over an 11-year period.

Methods A database of patients diagnosed with CHD on antenatal ultrasound or within 12 months of delivery was collated from January 2010 to December 2020. A retrospective review of records was performed to establish the incidence of CHD and the antenatal detection rate (ADR). A Fisher's exact test was used to investigate the association between the type of CHD, the presence of a genetic abnormality, extracardiac anomalies, and the ADR.

Results The incidence of CHD was 4.3 per 1,000 maternities (n = 161). Fifty-five percent of anomalies were diagnosed antenatally. Twenty-seven percent underwent termination of pregnancy. Seventy-three percent of cases were alive at the end of follow-up. Patients with a major form of CHD were more likely to receive an antenatal diagnosis compared with those with other forms of CHD (64.9% vs. 39.1%, p 0.002). The presence of extracardiac abnormalities was associated with a higher ADR.

Conclusion The incidence of CHD was 4.3 per 1,000 maternities. Most major cardiac anomalies were diagnosed antenatally. Detection rates varied depending on the nature of the lesion and the presence of other congenital anomalies.

Implications for Clinical Practice Cardiac anomalies are the most common form of birth defect. Reported incidence rates lie between 4 and 20 per 1,000 live births. This study describes the incidence, pregnancy outcomes, and ADR of cardiac anomalies within one Scottish health board. It provides insight into the effectiveness of a national screening program in detecting CHD and the factors that influence ADR. Therefore, it can be used to more effectively counsel patients on the strengths and limitations of antenatal ultrasound for detecting CHD.

Keywords

heart defects - congenital - fetal screening - antenatal diagnosis

Note

This original research has never been presented or published.


Authors' Contributions

N.P. conceived and designed the study. I.C. and E.C. contributed to data collection. E.C. performed data analysis and wrote the manuscript with supervision from N.P. All authors have reviewed the final manuscript.


Ethical approval

This retrospective review of health records was registered with the local audit office and conformed to the ethical principles outlined in the Declaration of Helsinki.




Publication History

Article published online:
25 July 2024

© 2024. Society of Fetal Medicine. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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