Received: 7 May 2014 /
Accepted: 23 July 2014
©Springer Science+Business Media New York 2014
ISSN 0172-0643
Pediatr Cardiol
DOI
10.1007/s00246-014-0996-1
Moving Towards Universal Prenatal Detection of Critical Congenital
Heart Disease in Southern Nevada: A Community-Wide Program
Authors
William Evans, MD, William
Castillo, MD, Robert Rollins, MD, Carlos Luna, MD, Katrinka Kip, MD, Joseph
Ludwick, MD, Nitin Madan, MD, Michael Ciccolo, MD, Alvaro Galindo, MD, Abraham
Rothman, MD, Gary Mayman, MD, Kathleen Cass, MD, Vincent Thomas, MD, Humberto
Restrepo, MD, MPH, Ruben Acherman, MD
Source
ChildrenŐs Heart Center
Nevada, 3006 S Maryland Pkwy, Ste 690, Las Vegas, Nevada 89109, USA. Email: wnevans50@aol.com.
Abstract
This study compares the
current, prenatal detection rate for critical congenital heart disease in
Southern Nevada with the previously reported rate, after developing and
expanding a comprehensive, communitywide fetal cardiology program. For the
current-period analysis, we inquired our database and electronic health records
for patients born in Clark County, Nevada, with critical congenital heart
disease between May 2012 and April 2014, and we compared the results with the
previous period between May 2003 and April 2006. The major components of the
community-wide program include fetal congenital heart disease screening via
general obstetric ultrasound studies performed in obstetricianŐs offices,
radiology imaging centers, or maternal–fetal medicine specialty
practices; subsequent referral for comprehensive fetal echocardiography
performed in maternal–fetal medicine offices under the on-site
supervision by fetal cardiologists; and recurring community educational programs
teaching the 5-axial plane, fetal echocardiographic screening protocol to
general obstetric sonographers and instructing perinatal sonographers in
advanced imaging topics. For the current period, the prenatal detection rate
for critical congenital heart disease in Southern Nevada was 71versus 36 % for
the previous period (p\ 0.001). The temporal improvement in prenatal detection
of critical congenital heart disease may be related to our expanded
decentralized, community-wide fetal cardiology program,
and our
experiences may be applicable to other metropolitan areas.