A review of the diagnostic accuracy of fetal cardiac anomalies

Objectives: In order to assess the diagnostic accuracy of fetal cardiac anomalies in our Department we undertook a retrospective analysis and compared our results with those of the paediatric cardiologists in the same cases. Methods: Sixty‐five patients referred for second and third trimester fetal echocardiographic examinations were identified in our database from November 2005 to February 2014. Of these six scans were found to be normal by ultrasound and not referred on to the paediatric cardiologist. An additional six scans were diagnosed to have complex congenital heart disease (CHD) with or without extra cardiac abnormalities and/or aneuploidy. These six patients opted for termination of pregnancy and were also not seen by the paediatric cardiologist. The remaining 53 cases were referred to the paediatric cardiologist. Our results were analysed and then compared to the cardiologist's findings. There were an additional three cases scanned during the pregnancy in our department and diagnosed as normal but ultimately found in the neonatal period, to have CHD. Results: The ultrasound findings of the 53 cases scanned in our department were analysed and compared to the findings in the cardiologist's reports. The earlier scans tended to describe the abnormal anatomy but showed a reluctance to name any pathology. As training and confidence levels increased the less complex pathologies were correctly identified by our department and confirmed by the cardiologist. Conclusion: The skills, training and level of confidence required to diagnose fetal cardiac anomalies in our Department have improved over the eight years of the study period, particularly in regards to some of the less complex cardiac pathologies. However the more complex pathologies remain difficult to assess.