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Fetal cardiac screening; why bother
BMJ - Archives of Diseases in Childhood, 08/21/09

Sharland G – Reports indicate that approximately 25% of babies with severe forms of congenital heart disease are still discharged from hospital undiagnosed and in some cases the cardiac lesion is not recognised during life. Early diagnosis of such babies would improve survival, as well as reducing the morbidity associated with circulatory collapse prior to recognition of a problem and administration of appropriate treatment.

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Gurleen Sharland, 08/24/09

This paper highlights that antenatal diagnosis of congenital heart disease in high risk groups seen in specialist centres is well established and can be associated with an improved outcome, as well as allowing parental choice and time for parental preparation. Antenatal screening for congenital heart disease in low risk groups is also possible, but requires resources for teaching and training as well as time during obstetric anomaly scans to examine the fetal heart. There is currently a huge regional variation in the UK for the prenatal detection rates of congenital heart disease as a result of screening at the time of the obstetric anomaly scan. This difference needs to be addressed so that all pregnant women have access to the same standard of fetal heart examination during obstetric ultrasound screening. A national database and audit is also recommended.

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