Prenatal detection of congenital heart disease
This report evaluates the results of a screening program on prenatal detection of congenital heart defects in a geographical cohort of western Sweden.

To determine prenatal detection rate, all neonates who underwent surgery or catheter intervention for a critical congenital heart defect were included. The four-chamber view was implemented into the routine scan in 2009 and implementation of the ISUOG guidelines, including the outflow tracts, started in the region in 2015.

- 113 fetuses received a prenatal diagnosis of a major congenital heart defect. 89% of these were referred because of a suspected cardiac malformation and 88% were diagnosed before 22 completed weeks.

- 59% of the patients diagnosed before 22 completed weeks opted for termination of pregnancy. During 2014–2016, 61 fetuses had a prenatal diagnosis of a critical congenital heart defect, and a further 47 were diagnosed after birth, hence 56% were diagnosed prenatally, 82% for those which had a combination with an extracardiac abnormality and/or chromosomal aberration compared to 50% if an isolated critical congenital heart defect was diagnosed.

- For single ventricle cardiac defects such as hypoplastic left heart syndrome, double inlet left ventricle, and tricuspid atresia, the detection rate was 100%.

- The detection rate for transposition of the great arteries and coarctation of the aorta was 9 and 18% respectively.

56% of all fetuses with a critical congenital heart defect were diagnosed prenatally during 2014–2016 and approximately 53% of all major congenital heart defects 2013–2017 as compared to 13.8% in 2009 in the same region. An increased focus on the fetal heart in the routine scan improved the prenatal detection rate of major congenital heart defects.

BMC Pregnancy and Childbirth