Suspected heart anomalies will require more comprehensive evaluation using fetal echocardiography 26. This approach also helps to identify fetuses at risk for genetic syndromes and provides useful information for patient counseling, obstetric management and multidisciplinary care. These Guidelines can be used in the evaluation of low-risk fetuses examined as part of routine prenatal care 23- 25. The cardiac screening examination of the fetus is designed to maximize the detection of heart anomalies during a second-trimester scan 22. As one example, the detection rate of major cardiac anomalies doubled after implementation of a 2-year training program at a medical facility in Northern England 21. Continuous feedback-based training of healthcare professionals, a low threshold for echocardiography referrals and convenient access to fetal heart specialists are particularly important factors that can improve the effectiveness of a screening program 8, 20. Some of this variation can be attributed to differences in examiner experience, maternal obesity, transducer frequency, abdominal scars, gestational age, amniotic fluid volume and fetal position 18, 19. Prenatal detection of CHD may improve the outcome of fetuses with specific types of cardiac lesions 12- 16, but prenatal detection rates vary widely 17. Structural cardiac anomalies were also among the abnormalities most frequently missed by prenatal ultrasonography 10, 11. Between 19, 42% of infant deaths reported to the World Health Organization were attributable to cardiac defects 9. The new ISUOG recommendation that outflow tract views as well as the four-chamber view be added to routine screening is evidence-based and parallels recent guidelines and recommendations from other professional bodies 2- 5.ĬHD is a leading cause of infant mortality, with an estimated incidence of about 4– live births 6- 8. This document constitutes a revised and updated version of the previously published ISUOG guidelines for cardiac screening in midgestation 1 and reflects current knowledge about prenatal detection of congenital heart disease (CHD). Approved Guidelines can be distributed freely with the permission of ISUOG ( ). The ISUOG CSC documents are not intended to establish a legal standard of care because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accept any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. ![]() They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements that provide healthcare practitioners with a consensus-based approach for diagnostic imaging. The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages safe clinical practice and high-quality teaching and research related to diagnostic imaging in women's healthcare.
0 Comments
Leave a Reply. |