PRENATAL-DIAGNOSIS OF CONGENITAL CARDIAC DISEASE - AN EXAMPLE OF TEAMWORK BETWEEN OBSTETRICIANS AND PEDIATRICIANS

The frequency of congenital cardiac disease is about 8/1000 births. Th e most severe forms, which contribute about half the cases, can be det ected by prenatal ultrasonography. Initially ultrasonographic detectio n of cardiac defects was reserved for high-risk patients, particularly those who had a family member with a congenital cardiac defect. Since 1983, ultrasonographists, obstetricians, and pediatric cardiologists have been working in close collaboration. The main cardiac structures and the great arteries are closely scrutinized during the ultrasonogra phy done during the second trimester of pregnancy If anomalies are fou nd or suspected, a pediatric cardiologist specialized in fetal ultraso nography performs a detailed ultrasonographic examination to establish the exact diagnosis, and informs the parents. Plans are made for trea ting the patient at birth, especially when the defect is ductus-depend ent or involves transposition of the great arteries. The same strategy is also for fetal heart rhythm disturbances, which are often amenable to pharmacotherapy. About 70 % of cases of hypoplastic left heart syn drome and 20-25 % of cases of tetralogy of Fallot are now diagnosed pr enatally, but other defects remain underrecognized, attesting to the n eed for improved training of ultrasonographists in the analysis of fet al cardiac structure.