Flavia Ventriglia
University of Rome, Italy
Title: Early Fetal Echocardiography: Early Congenital Heart Diseases Detection in an Experienced Fetal Cardiology Project.
Biography
Biography: Flavia Ventriglia
Abstract
Background Early fetal echocardiography (EFE) is a diagnostic test of tertiary level, performed at 12-16 weeks gestational age (GA). EFE is usually carried out to diagnose earlier severe congenital heart diseases (CHD). However EFE showed some significant limitations: Crown-Rump Length value <50mm; increased maternal Body Mass Index; unfavourable fetal position; likelihood progression of the detected CHD. Material And Methods A multidisciplinary research protocol, approved by the ethics committee, is conducted in our universitary hospital to diagnose fetal CHDs as early as possible, alone or associated with extracardiac malformations or genetic abnormalities. From January 2014, 75 pregnant from 12th to 16th weeks of gestation came to our Fetal Echocardiography Service and underwent the scan according to the international cardiac protocol, using a 3D Convex trans abdominal volumetric probe, frequency range of 4-8 mHz.
Results: Pregnant women were divided into 6 groups: 1): 16 pregnants came in for screening (21%) 2): 10 pregnants affected by disease (14%). 3): 6 pregnants with a family history of genetic/chromosomal disorders (8%). 4): 15 pregnants with a family history of CHD (20%). 5): 24 pregnants with obstetric screening abnormalities (increased Nuchal translucency (11); cystic hygroma (9); malformations (3); tricuspid regurgitation (1) (32%). 6): 4 pregnants with suspected fetal CHD at obstetric screening (5%) Discussion And Conclusions From the clinical study, it emerges how the cardiac protocol enables a significantly more accurate early diagnosis of CHD, particularly if compared to gynecologic and obstetric protocols. To date, population screening does not appear to be necessary. In fact, EFE allows detecting CHD in high-risk groups (5-6) and it plays an important role from the psychological point of view in excluding a CHD in a second pregnancy, after a first pathological one (group 4). It’s possible confirm that the cardiologic transabdominal approach to EFE is usefull for early diagnosis of CHDs and for the study of their progression during gestational period, allowing a multidisciplinary support for a subsequent better management of pregnancies.