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KMID : 0606620070030010019
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Korean Journal of Fetal Medicine
2007 Volume.3 No. 1 p.19 ~ p.26
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Prenatally-Diagnosed Congenital Heart Disease: Outcomes and Correlation with Postnatal Diagnosis
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Kim Sei-Eun
Choi Suk-Joo
Jung Kyung-Lan
Oh Soo-Young
Kim Jong-Hwa
Roh Cheong-Rae
KO Ok-Jin
Park Yu-Na
Nam Soo-Hyun
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Abstract
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Objective: To investigate the outcome of prenatally-diagnosed fetal congenital heart disease (CHD) and to assess the level of agreement between the prenatal and postnatal echocardiographic diagnosis.
Method: From December 1994 to December 2005, 373 pregnant women were diagnosed as fetal congenital heart disease by prenatal echocardiography. We investigated maternal age, gestational age at diagnosis, gestational age at delivery, the results of prenatal and postnatal fetal echocardiography, mode of delivery, associated anomaly, chromosomal abnormality, perinatal mortality and infant mortality. Cases which at least one year follow-up data were available through reviewing of medical records or telephone interview were included in our final study population.
Results: Fetuses of 373 pregnant women were diagnosed as congenital heart disease by prenatal fetal echocardiography, data were available in 331 cases (89%). In this study, mean gestational age of cases at diagnosis was
28.0±5.7 weeks and mean gestational age at delivery was 37.8±2.9 weeks. Pregnancy termination rate was 19% (63/331). The incidence of associated extracardiac anomaly and chromosomal abnormality was 30% (74/245) and 10% (9/87), respectively. Overall agreement of prenatal and postnatal diagnosis was 72%. Agreement of prenatal and postnatal echocardiography was highest in cases of Transpostion of great arteries (TGA) and Tetralogy of Fallot (TOF) (85.7%, 83.3%, respectively), followed by Pulmonary stenosis (PS), Atrioventricular septal defect (AVSD), Double outlet of right ventricle (DORV) and Cardiac tumor (70.6%, 66.7%, 66.7%, and 50%, respectively). The agreement was lowest in cases of Coartation of aorta (CoA) and Ventricular septal defect (VSD) (18.8%, 34.8%, respectively). The perinatal mortality and infant mortality was 6.9% (16/233) and 9.4% (22/233) in overall population and 3.1% (5/159) and 4.4% (7/159) in cases with no associated extracardiac anomaly in prenatally-detected cogenital heart disease.
Conclusion: 1) Outcomes of prenatally-diagnosed congenital heart diseases are substantially improved compairing with previous studies. 2) The level of agreement between the prenatal and postnatal echocardiographic diagnoses were different according to the type of fetal congenital heart disease.
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KEYWORD
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Fetal congenital heart disease, Prenatal diagnosis, The level of agreement, Perinatal mortality, Infant mortality
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