FETAL ECHOCARDIOGRAPHY IN GRAVIDAS WITH HISTORIC RISK-FACTORS FOR CONGENITAL HEART-DISEASE

All fetal echocardiograms performed at our institution between January 1, 1986, and June 1, 1991, were reviewed. The echocardiogram referral indication and results were verified for all women studied. Historic risk factors under consideration were pregestational diabetes, anticon vulsant or lithium ingestion in the first trimester, and a family hist ory of congenital heart disease. Women with historic risk factors who had either a fetal abnormality on antenatal sonography or a known aneu ploid fetus prior to the fetal echocardiograph were excluded. Of the 9 94 women who had a fetal echocardiogram performed during this study pe riod, 486 (48.9%) were evaluated solely on the basis of a historic ris k factor. Four of the 486 women (0.8%) were diagnosed as having a sign ificant fetal structural cardiac malformation. Two of the four fetuses succumbed to obstetric complications. The remaining two infants were delivered at term and are doing well after postnatal cardiac surgery. In this select group of women with risk factors but no recognized feta l abnormality, the incidence of significant cardiac lesions was low. A lthough indications for fetal echocardiography must be evaluated on an individual basis, our data do not support a recommendation for the ro utine use of fetal echocardiography as a screening test in all women w ith historic risk factors.