Cyanosis primary prevention
|
Cyanosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Cyanosis primary prevention On the Web |
|
American Roentgen Ray Society Images of Cyanosis primary prevention |
|
Risk calculators and risk factors for Cyanosis primary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Prenatal diagnosis
Clinicians skilled at fetal echocardiography are able to identify most congenital heart defects. However, clinical suspicion or a risk factor for CHD must be identified to prompt referral for fetal echocardiography. Routine antenatal ultrasound traditionally included assessment of the fetal heart using the four chamber view; however, the practice guidelines of the International Society for Ultrasound in Obstetrics and Gynecology (ISUOG) published in 2013 now recommend expanded views for screening, including assessment of the outflow tracts [41]. Studies performed in the era prior to publication of these guidelines indicate that less than half of patients with critical congenital heart defects were routinely identified [10,42-44]. CHD lesions involving abnormal outflow tracts (including tetralogy of Fallot (figure 2), double outlet right ventricle [DORV], and transposition of the great arteries [TGA] (figure 3)) are particularly at risk for not being identified. In addition, coarctation of the aorta (COA) (figure 4) is difficult to definitively diagnose prenatally.
The expanded prenatal screening recommendations of the ISUOG may lead to improved detection rates in the future. One study found that the rate of prenatal detection of critical CHD increased from 44 percent in 2007 to 69 percent in 2013 [43].
Prenatal sonographic screening for CHD is discussed in detail separately.