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DOI: 10.1007/s40556-020-00250-x
Referral Pattern for Fetal Echocardiography Over 10 Years in a Single Fetal Imaging Centre from Southern India
Abstract
Aim To study the trend in referral patterns for fetal echocardiography (FE) and the outcome
Methods Retrospective study of fetuses referred to a single fetal imaging center for FE from Jan 2008 to Dec 2017. The study group was divided into group 1 (2008–2012) and group 2 (2013–2017). Indications were categorized into ‘low-risk’, ‘maternal-risk’ and ‘fetal-risk’. Detection of cardiac defect (CHD) was noted as abnormal outcome and it was analysed in relation to the referral indication.
Results The study group had 32,679 cases, 11,468 in group 1 and 21,211 in group 2. Total number of referrals showed an increase of 84% between first and second half of study. ‘Low-risk’ referrals were the most common in both groups but high risk referrals had shown an increase of 24.5% over years. Maternal diabetes was the most common ‘maternal-risk’ factor and abnormal cardiac finding in obstetric scan was the common ‘fetal-risk’ indication. Incidence of CHD increased from 4.6 to 10.2% during the study period. CHD was seen more in ‘fetal-risk’ indications (65%) compared to other risk groups (p < 0.05). Maternal-risk indications individually did not show a significant relationship to CHD. Abnormal cardiac findings in scan, extra-cardiac anomaly, aneuploidy screen positivity, single umbilical artery, growth and liquor abnormality showed a higher risk for CHD. Among low-risk 22.5% showed CHD.
Conclusion Referral of high-risk cases for FE has increased recently. Abnormal fetal findings in scan or screening tests was significantly associated with fetal CHD. A significant percentage of CHD was detected in the low-risk group. Strengthening fetal cardiac screening is needed to optimise appropriate risk stratification as well as to increase detection of cardiac anomalies.
Publication History
Received: 17 December 2019
Accepted: 16 March 2020
Article published online:
05 May 2023
© 2020. Society of Fetal Medicine. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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