Statistical Analysis of Fetal Echocardiography Clinic at Fetal Care Unit Ain Shams Maternity Hospital over a 12-month period

Abstract

CHDs are one of the most common congenital anomalies. Their estimated incidence is approximately about 6 in 1,000 live births and about 8 to 10 in 1,000 pregnancies (Rodger, 2010). CHDs lead to about 40% of perinatal deaths (Abu-Harb et al., 1994) of which more than 20% these deaths occur during the first month of life (Young and Clarke, 1987). Therefore, CHDs significantly share in the economic burden on health care systems. FE is the only means of detecting such defects (Nayak et al., 2016). Improvement in FE during the past two decades has allowed for the prenatal diagnosis of most types of CHD (Allan and Sharland, 2001). Technical achievements in sonographic systems to detect the most severe forms of heart malformations (Montana et al., 1996), increase the ability of a prenatal diagnosis of CHD- affected fetuses (Huggon et al., 2004). Diagnosis of major CHD early in pregnancy leads to the benefit of families by allowing the option of earlier and more private (before the pregnancy is noticeable by the surrounding) (Johnson and Simpson, 2007),and safer pregnancy termination (Bronshtein et al., 2008), with less psychological consequences (Korenromp et al., 2005) and, very importantly, in case of normal scan, earlier reassurance (Khalil and Nicolaides, 2013). The aim of this work is to evaluate the FE as an emerging diagnostic tool for early detection of CHD. This study was performed over a 12-month period from November 2014 to October 2015, during which 101 pregnant women were examined by FE at the ultrasound special care unit for the fetus at the obstetrics and gynecology hospital at Ain Shams university. All pregnant mothers were subjected to the following:  Full medical and surgical history taking laying stress on:  Personal data including maternal and paternal ages, consanguinity and gestational age  Obstetric history (parity, previous abortions, still births, ART)  Maternal risk factors for fetal heart affection such as active and passive smoking, maternal infections, maternal medications, obesity, metabolic disorders and rheumatic heart disease.  Occupational or environmental or medical or accidental exposure of the mother to ionizing radiation as a risk factor for fetal heart affection stressing on the type and duration of exposure to radiation.  Family history of previous congenital heart diseases or chromosomal anomalies.  Routine obstetric ultrasound was done to detect any extra-cardiac abnormality such as, hydrops fetalis, increased first trimester nuchal translucency, multiple gestations, …  Fetal echocardiography to detect any structural or rhythm abnormalities in the fetal heart following the guidelines and standards of the American Society of Echocardiography for performance of the fetal echocardiogram.  Neonatal echocardiography was done after delivery and its results were compared to the fetal echocardiography results. A standard two-dimensional (2D), m-mode, color flow (CF), doppler echocardiography examination was performed. Views included four chamber view, five chamber view, long axis view (left ventricular outflow and right ventricular outflow), 3-vessel and trachea view, ductal arch view and aortic arch view. This was done using “GE Voluson E6” ultrasound system machine. The ages of the included study population ranged from 17 to 42 years old with a mean (28.09) years and SD of (± 5.19), and their gestational age ranged from 16 to 38 weeks with a mean (28.37) weeks and SD of (± 5.49). The paternal age ranged from 24-48 years old, with a mean of (32.13) years and SD of (± 5.39). Consanguinity between the pregnant female and her husband was found to be positive in 32 females (31.7%) and negative in 69 females (68.3%).