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Screening of congenital heart disease in the second trimester of pregnancy: current knowledge and new perspectives to the clinical practice

Published online by Cambridge University Press:  15 November 2013

Luciane Alves Rocha ,
Edward Araujo Júnior ,
Liliam Cristine Rolo ,
Fernanda Silveira Bello Barros ,
Karina Peres Silva ,
Luis Henrique Martinez ,
Luciano Marcondes Machado Nardozza  and
Antonio Fernandes Moron
Luciane Alves Rocha
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Edward Araujo Júnior*
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Liliam Cristine Rolo
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Fernanda Silveira Bello Barros
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Karina Peres Silva
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Luis Henrique Martinez
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Luciano Marcondes Machado Nardozza
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
Antonio Fernandes Moron
Affiliation:
Department of Obstetrics, Fetal Cardiology Unit, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
*
Correspondence to: Prof E. Araujo Júnior, PhD, Department of Obstetrics, Federal University of São Paulo (UNIFESP), Rua Carlos Weber, 956 apto. 113 Visage, Alto da Lapa, São Paulo, SP, CEP 05303-000, Brazil. Tel/Fax: +55 11 37965944; E-mail: araujojred@terra.com.br
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Abstract

Objective

Congenital heart diseases are common in foetuses, with an incidence greater than six times that of chromosomal abnormalities; however, experts in cardiac anatomy have evaluated only the foetuses of pregnant women with increased risk for congenital heart disease. Over the years, it has become clear that congenital heart disease occur in foetuses of low-risk women. In the mid-1980s, a proposal to expand the assessment of cardiac anatomy was presented to obstetricians in order to improve prenatal screening. With the aim to systematise and improve the diagnosis of congenital heart disease in foetuses, the International Society of Ultrasound in Obstetrics and Gynecology established an ultrasound heart examination guideline. In this review, we have described the important features of this guideline and discussed the applications of this tool in clinical practice.

Methods

We performed a literature search of the National Library of Medicine for publications released between 2000 and 2012; we used search terms pertinent to congenital heart disease, such as foetal echocardiography, foetal heart and cardiac screening examination.

Results

The guidelines serve as a standard and help to systematise the screening for congenital heart diseases, but we think that some topics may be added to design the most appropriate screening method. However, we cannot expand the topics to be evaluated in this examination without good training of sonographers who undergo this screening.

Conclusion

Although the screening standardisation is a good tool to be used in day-to-day practice, the increment of aortic and ductal archs and colour Doppler to heart screening could be useful to detect further cardiac defects.

Keywords

Screeningcongenital heart diseaseechocardiographyguidelines
Type
Review Articles
Information
Cardiology in the Young , Volume 24 , Issue 3 , June 2014 , pp. 388 - 396
Copyright
Copyright © Cambridge University Press 2013 

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