Efficacy of Fetal Echocardiography and an Evaluation of Indications
Jarupim Soongswang MD*, Wiboolphan Thitadilok MD**, Prasert Sunsaneevithayakul MD**, Anuwat Sutanthavibul MD**, Pornpimol Ruangvutilert MD**, Kanchana Wansanit BSc***, Kesaree Punlee BSc***, Suteera Phrudprisan BSc***, Charuwan Kangkakate MSc (Biostat)****
Affiliation : * Division of Cardiology, Department of Pediatrics, ** Department of Obstetric & Gynecology *** Her Majesty Cardiac Center, **** Clinical Epidermiology Unit, Office of Research Promotion, Faculty of Medicine Siriraj Hospital, Mahidol University
Fetal echocardiography has been accepted as a prenatal noninvasive diagnostic tool of cardiovas-
cular diseases in fetuses for more than three decades. There are limited data in Thailand. A retrospective study
of prenatal, natal and postnatal data of pregnant women who had fetal echocardiography at Siriraj Hospital,
Bangkok, Thailand, from January 1999 to July 2005 was conducted. In total, there were 117 pregnant women
who had fetal echocardiography under standard indications. Median age of pregnant women was 30.2 (17.3-
44.2) years old. Median gestational age at the first fetal echocardiography was 29 (17-40) weeks. Median
number of time the women had fetal echocardiography was 1 (1-10). Indications for fetal echocardiography
were; obstetricians suspected of fetal cardiovascular diseases, multiple anomalies, family history of congeni-
tal heart diseases, chromosome anomalies, hydrops fetalis, and other indications (53.8%, 12%, 11.1%, 8.5%,
8.5% and 6.0% respectively). There were 49 (41.8%) cases who had abnormal cardiovascular problems, i.e.,
structural heart diseases 26 cases, rhythm disturbance 15 cases, and cardiac masses 8 cases. Upon compari-
son with postnatal echocardiography and/or autopsy findings, fetal echocardiography had a sensitivity of
96.9%, specificity of 90.6%, and accuracy of 92.8%. There was various degrees of risk to have cardiovascular
problems for each of the indication taking fetal echocardiography and postnatal data into consideration.
Fetal echocardiography had an impact on the management in 57.3% of cases.
Conclusion : Fetal echocardiography is a reliable prenatal diagnostic tool for cardiovascular problems with
high accuracy and has an impact on the management at prenatal, natal and postnatal period. Different
indications for fetal echocardiography have an effect on the relative risk of fetal cardiovascular diseases.
Keywords : Prenatal diagnosis, Fetal echocardiography
