Factors causing timely referral for fetal echocardiography in the final diagnosis of congenital heart malformations: A cross-sectional study

Congenital heart disease (CHD) is one of the most frequently inherited illnesses associated with adverse outcomes.

This study aimed to determine the referral cause for fetal echocardiography in the final diagnosis of major CHD.

In this cross-sectional study, the data of 1772 pregnant women, referred to a diagnostic clinic during 2017-2020, were reviewed. Data were collected from participants on maternal age, gestational age, history of previous child's heart disease, body mass, the order of birth of children (baby birth rank), type of woman’s disease, history of poor midwifery, and nuchal translucency (NT).

Of the 1772 pregnant women, only 33 women (1.8%) had a fetus with CHD major. Abnormality in ultrasound (57.6%), history of abortion (36.4%), increased NT and gestational diabetes (18.2%) and Gestational diabetes (18.2%) were identified as the most common referral reasons for fetal echocardiography in these women. Other reason included previous child with Down syndrome (12.1%), previous child with heart disease (12.1%), a history of stillbirth (12.1%), hypothyroidism (12.1%), taking medication during the pregnancy period (9.0), no underlying disease (9.0), multiple pregnancies (6.0%), diagnosis with high-risk fetal heart disease (3.0%), High-risk combined aneuploidy screening test in first trimester (3.0%), in vitro fertilization pregnancy (3.0%), and having a child with intellectual disability (3.0%).

According to the results, it can be concluded that ultrasounds abnormality, abortion, increased NT and gestational diabetes are the most important factors for referring pregnant women for fetal echocardiography.