Resident Physician Children's Hospital of the University of Illinois Chicago, Illinois, United States
Background: Congenital heart disease (CHD) is one of the most common birth defects, with an incidence of 6 per 1000 live births. Fetal echocardiograms are currently obtained based on maternal risk factors, fetal risk factors, and family history that may increase the likelihood of a congenital heart defect in the fetus. As a minimally invasive diagnostic modality with low risk to both the mother and child, fetal echocardiography is a desirable method of detection that can predict neonatal outcomes, thereby guiding decision-making both in the prenatal and postnatal period. However, only 50% of infants requiring cardiac surgery within the first year of life are detected prenatally. This is despite ongoing advances in echocardiography methods and utilization. Objective: The main objective of this study is to determine the sensitivity, specificity, positive predictive value, and negative predictive value of fetal echocardiography in predicting CHD at birth when compared with postnatal echocardiography. For cases in which both fetal and postnatal echocardiogram showed abnormal cardiac structure, the rate of concordance of diagnoses made was also determined as an additional measure of diagnostic accuracy. A secondary goal of this study is to identify factors that may affect diagnostic accuracy, such as gestational age or interpreting provider. Design/Methods: IRB approved this study on August 16, 2022. A retrospective study was performed, comparing the interpretation of fetal echocardiograms to that of postnatal echocardiograms obtained within a week following birth. The patient population consisted of pregnant women with fetal echocardiograms and corresponding infants with postnatal echocardiograms performed at a single institution from January 2018 – December 2021. Diagnostic measures were first determined for fetal echocardiograms interpreted by a single provider and obtained in the 2nd trimester. These measures were then calculated for fetal echocardiograms with other criteria to identify factors that may impact on diagnostic accuracy.
