Received July 11, 2007, from the ChildrenŐs Heart Center, Las Vegas, Nevada USA
© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 2007; 26:1715–1719
Revised manuscript accepted for publication August 21, 2007
Prenatal Detection of Congenital Heart Disease in Southern Nevada - The Need for Universal Fetal Cardiac Evaluation
Ruben J Acherman, MD, William N Evans, MD, Carlos F Luna, MD, Robert Rollins, MD, Katrinka T Kip, MD, Juan C Collazos, MD, Humberto Restrepo, MD, MPH, Joseph Adasheck, MD, Brian K Iriye, MD, Donald Roberts, MD, Alan J Sacks, MD
ChildrenŐs Heart Center Nevada, 3006 S Maryland Pkwy, Suite 690, Las Vegas, NV 89109 USA.
Objective. Congenital cardiac malformations are common developmental anomalies. In the United States, congenital heart disease is the number one cause of infant mortality from congenital malformations. Prenatal diagnosis of congenital heart defects aids treatment coordination. Our aim was to evaluate prenatal detection of serious congenital heart malformations in Clark County, Nevada.
Methods. We electronically searched our research department–maintained computer database for patients with serious congenital heart disease born in Clark County between May 2003 and April 2006. We excluded patients that did not have at least 1 local prenatal ultrasound examination. All prenatal ultrasound studies were performed in obstetric offices, radiology imaging centers, or maternal-fetal medicine specialty practices. Fetal echocardiography was performed in maternal-fetal medicine specialistsŐ offices under the supervision of a fetal cardiologist. Pediatric cardiologists performed all postnatal echocardiographic examinations.
Results. During the study period, we diagnosed serious congenital heart malformations in 161 patients among a total estimated 77,000 births (2/1000). Of the 161 patients, 58 (36%) had a prenatal diagnosis, and 103 (64%) had an exclusively postnatal diagnosis.
Conclusions. Standard prenatal ultrasound fails to show congenital heart disease in most fetuses.