%0 Journal Article
%T Prenatal Detection of Congenital Heart Diseases: One-Year Survey Performing a Screening Protocol in a Single Reference Center in Brazil
%A Luciane Alves Rocha
%A Edward Araujo J¨˛nior
%A Liliam Cristine Rolo
%A Fernanda Silveira Bello Barros
%A Karina Peres da Silva
%A Ana Teresa Figueiredo Stochero Leslie
%A Luciano Marcondes Machado Nardozza
%A Antonio Fernandes Moron
%J Cardiology Research and Practice
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/175635
%X Objective. To describe the experience of a tertiary center in Brazil to which patients are referred whose fetuses are at increased risk for congenital heart diseases (CHDs). Methods. This was a cross-sectional observational study. The data was collected prospectively, during the year 2012, through a screening protocol of the fetal heart adapted from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. We performed a fetal echocardiogram screening for all pregnant women who were referred to the fetal cardiology outpatient obstetrics clinic of a university hospital. The exams were classified as normal or abnormal. The cases considered abnormal were undergone to a postnatal echocardiogram. We categorized the abnormal fetal heart according to severity in ˇ°complex,ˇ± ˇ°significant,ˇ± ˇ°minor,ˇ± and ˇ°others.ˇ± Results. We performed 271 fetal heart screening. The incidence of abnormal screenings was 9.96% (27 fetuses). The structural CHD when categorized due to severity showed 48.1% ( ) of ˇ°complexˇ± cases, 18.5% ( ) ˇ°significantˇ± cases, and 7.4% ( ) ˇ°minorˇ± cases. The most common referral reason was by maternal causes (67%) followed by fetal causes (33%). The main referral indication was maternal metabolic disease (30%), but there was just one fetus with CHD in such cases (1.2%). CHDs were found in 19/29 fetuses with suspicion of some cardiac abnormality by obstetrician (65.5%). Conclusion. We observed a high rate of CHD in our population. We also found that there was higher incidence of complex cases. 1. Introduction Congenital heart diseases (CHDs) are the most common abnormalities in fetuses, being six times more common than chromosomal abnormalities and four times more common than neural tube defects [1]. The incidence of CHD with intrauterine diagnosis ranges from 2.4% to 54% [2¨C7]. Some countries have high incidence of CHD because they have instituted an organized policy to perform heart screening by ultrasound systematically [8¨C10]. A detail evaluation of the fetal heart optimizes the diagnosis of CHD [11]. This provides an appropriate prenatal and postnatal planning, enabling an improvement in neonatal morbidity and surgical outcome [1, 12¨C15]. Therefore, there is an increasing interest in improving detection of the cardiac defects. There are many epidemiological and ultrasonographic data reported [2¨C7]; however, to the best of our knowledge, there are no published Brazilian epidemiological data. Our aim is to describe the experience of a tertiary center in Brazil to which patients are referred whose fetuses are at
%U http://www.hindawi.com/journals/crp/2014/175635/