1. ¹The Heart Institute for Children, Oak Lawn, IL, USA
2. ²Departments of Obstetrics and Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
3. ³Section of Maternal Fetal Medicine, Department of Obstetrics, Lutheran General Hospital, Park Ridge, IL, USA
4. ⁴Advocate Health Care Office of Medical Education and Research, Park Ridge, IL, USA

Correspondence: Bettina F. Cuneo, MD, The Heart Institute for Children, 4440 W. 95th Street, Oak Lawn, IL 60445, USA

Abstract

OBJECTIVE: Prenatal diagnosis of critical (requiring neonatal intervention) cardiac defects (critical congenital heart diseases (CCHD)) improves survival, yet detection of such malformations is poor. Our institution changed its practice and integrated a pediatric cardiologist into the perinatal team. The purpose of this study was to evaluate how this change affected the rate of detected congenital heart disease (CHD) and the diagnostic accuracy.

STUDY DESIGN: Obstetrical ultrasounds of mothers at high and normal risk for fetal CCHD at a single center between 1991 and 2001 were reviewed. Rate of detected CCHD, positive predictive values and false positives were compared before and after pediatric cardiology integration.

RESULTS: Between the first and second time periods, the rate of detected CCHD increased from 6.8/1000 ultrasounds to 12.9/1000 ultrasounds (p=0.007), and positive predictive value increased from 75 to 96%.

CONCLUSION: Collaboration with pediatric cardiology can significantly improve the rate of detected CCHD. These findings have significant implications for sonographer education and patient care.