Indications of Fetal Echocardiography and Detection of Congenital Heart Disease Prenatally in Tertiary Care Hospital.

Background Congenital Heart Diseases are common childhood congenital anomalies encountered in developed and developing countries. Due to the improved prenatal diagnostic modalities, the diagnosis of cardiac disease is increasing in newborns. Fetal echocardiography is considered a good and accurate diagnostic method for congenital heart disease. Objective To study the common indications of fetal echocardiography and the detection of congenital heart disease in Dhulikhel Hospital, Kathmandu University Hospital. Method In this hospital-based, retrospective study, we reviewed medical records of 324 fetuses who were indicated for fetal echocardiography at Dhulikhel Hospital over 24 months period of time (September 1, 2017 to August 31, 2019). Result The mean age of pregnant women at presentation for fetal echocardiography was 30.7 ± 4.7 years. The mean gestational age at diagnosis was 28.9 ± 4.9 weeks. Among all the pregnant women, 208 (65%) presented during the second trimester and 112 (35%) presented during the third trimester. Maternal indications for fetal echocardiography were seen in48.12% cases, whereas fetal indications were seen in 42.81% cases. The most common indication was for maternal gestational diabetes (30.31%). Among the 324fetal echocardiography results, 65.43% cases had normal findings, echogenic intra-cardiac foci were seen in 18.82% and significant abnormal findings were seen in 15.74% of cases. Among all women having maternal indication for echocardiography, 34 (22.07%) fetus had some form of abnormal findings, whereas only 17 (12.40%) fetus with fetal indication showed abnormal findings (p < 0.05). Conclusion Indication of fetal echocardiography is increasing and can be a good diagnostic tool to improve prognosis and outcome of a newborn. It has become widely used in pediatric cardiology. Raising awareness is necessary regarding the importance of fetal echocardiography in the management and outcome of a newborn with cardiac anomalies.