PRENATAL-DIAGNOSIS OF MAJOR CONGENITAL CARDIOVASCULAR MALFORMATIONS

This prospective study was designed to determine whether there would b e a higher incidence of congenital cardiovascular malformation (CCVM) in pregnant women with certain risk factors. Fetal echocardiography, f rom second trimester to term, was performed in 1,659 pregnant women wi th risk factors for CCVMs and 826 pregnant women without risk factors from March 1990 to April 1995. Two-dimensional imaging, fetal M mode m easurements, Doppler waveform velocity and Doppler color flow mapping were used for fetal heart examination. During this period, 70 fetuses with major cardiovascular malformations were found. The prenatal detec tion rate was determined as 2.8% (70/2,485) in our study. The rate in the high-risk group, however, was 3.7% (61/1,659). Of all indications, fetal risk factors had the highest rate (9.3%, 46/494) of detected CC VMs. Maternal and familial indications could be excluded from the high -risk group as they did not show any increased incidence over the low- risk group. We suggest that fetal echocardiography is mandatory in the high-risk group, especially in cases with fetal and placental risk fa ctors. Fetal cardiac screening in the hands of first-line sonographers has a major role in prenatal diagnosis of CCVMs in the low-risk group .