Abstract
In a recent 16 month period, 400 women were referred for F2DE. Indications for study were similar to those previously published. Using 8 2DE views and Doppler, when warranted, to better describe anatomic, rhythm or function abnormalities, we obtained complete studies in 95% of those studied.
In this highly selected group, we found: 7 with potentially life-threatening structural heart disease (SHD); 4 suspected of having SHD based on previously published descriptions; 4 with persistent well-characterized rhythm alterations without evidence of congestive failure and without SHD; and 1 with SHD and uncharacterized rhythm abnormality. With consent of families and referring obstetricians, fetuses suspected of having significant heart disease were followed; discussions of possible pre-and postnatal therapies were held regularly. In all cases perinatal management was altered because of the prenatal evaluation. Five have required surgery (3 as neonates; 2<6 mos); 2 have not required intervention; 1 died unexpectedly on day 2. Four fetuses with suspected left-sided obstructive lesions on the basis of associated findings continued postnatally to have non-specific 2DE changes; in none, however, could coarctation be found.
F2DE is a powerful tool in prenatal assessment. When significant heart disease is suspected, appropriate interventions can be planned and the neonatal outcome for babies with life-threatening heart disease improved. Of concern is the risk of false positive F2DE diagnosis and its impact on all resources; thus, ongoing reassessment of diagnostic criteria by pediatric cardiology is critical.
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Santulli, T., Williams, R. FETAL TWO-DIMENSIONAL ECHOCARDIOGRAPHY (F2DE): IMPACT ON PRENATAL MANAGEMENT AND POSTNATAL OUTCOME. Pediatr Res 21 (Suppl 4), 194 (1987). https://doi.org/10.1203/00006450-198704010-00167
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DOI: https://doi.org/10.1203/00006450-198704010-00167