Clinical significance of fetal echocardiography in diagnosing congenital cardiac anomalies: an experience from eastern India

Background: The role of early diagnosis of fetal cardiac abnormalities (both structural and functional) on the postnatal outcome has been controversial in literature for decade. Our objective was to evaluate the role of fetal echocardiography (FE) as a diagnostic tool for early detection of fetal cardiac abnormalities and its appropriate management plan. Results: This is a cross-sectional analytical and descriptive study that included 4366 singleton pregnant women (4366 fetuses) referred for FE from 2014 to 2022. Indications for referral and perinatal risk factors were documented. FE and postnatal transthoracic echocardiography were done. Maximum number of fetal echo done for the indication of presence of ICEF (1538, 35.2%). Routine FE done in 1199 (27.5%) individual. In 501(11.5%) individual had bad obstetric history. Fetal cardiac abnormalities were detected in 175 fetuses (4%). CHDs in 149 (3.4%), fetal arrhythmia in 17 (0.4%)cardiomyopathy in 3 (0.07%) fetuses and cardiac mass (Rhabdomyoma) in 6 fetuses (0.14%). Of the structural CHDs, maximum number of cases were large VSD, found in 24 (13.7%) cases, Four cases with tiny muscular ventricular septal defects and two cases with coarctation of aorta, one case of TGA with IVS and one case of large VSD were missed by FE and were diagnosed postnatal. Six cases of critical congenital heart disease were underwent early lifesaving neonatal intervention. Conclusions: FE can accurately diagnose most of the cardiac anomalies though few errors remain challenging (aortic coarctation). It also offers a good chance for successful early life saving management of some types of cardiac lesions.