@Article{chd.12584,
AUTHOR = {Rick D. Vavolizza, Pe’er Dar, Barrie Suskin, Robert M. Moore, Kenan W.D. Stern},
TITLE = {Clinical yield of fetal echocardiography for suboptimal cardiac visualization on obstetric ultrasound},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {3},
PAGES = {407--412},
URL = {http://www.techscience.com/schd/v13n3/38993},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Suboptimal cardiac imaging on obstetric ultrasound is a frequent referral indication for
fetal echocardiography, even in the absence of typical risk factors for fetal cardiac disease. The
clinical profile of patients and findings of examinations performed for such an indication are not
well defined. Given the increased cost, time and resource utilization of fetal echocardiography, we
sought to determine the clinical findings of such referrals.<br/>
<b>Study Design:</b> We performed a single-center review of such referrals from January 2010 to June
2016. Patients with commonly accepted indications for fetal echocardiography were excluded.
Demographic variables and echocardiogram findings were collected. Findings were classified as (1)
“normal,” (2) “probably normal,” if minor pathology could not confidently be excluded, or if minor
findings were noted that were expected to resolve, or (3) “abnormal.” Rates of pathology were
determined with comparison of nonobese and obese populations.<br/>
<b>Results:</b> A total of 583 gestations in 562 women were included (median gestational age 23.3
weeks, range 19.0–38.4). The median body mass index (BMI) was 34.6 kg/m<sup>2</sup> (range 17.2–
66.3 kg/m<sup>2</sup>
). The majority of women were obese (BMI ≥ 30 kg/m<sup>2</sup> in 74.6%). Overall, 574 of 583
examinations (98.5%) were normal or “probably normal.” Pathology was noted in 9 fetuses (1.5%),
3 of whom required intervention (0.5%). No ductal dependent lesions were diagnosed. There was
no significant difference in pathology rates between nonobese and obese mothers.<br/>
<b>Conclusions:</b> We found a low fetal cardiac anomaly rate in studies performed for suboptimal views
on obstetric ultrasound. The majority of women referred for this indication were obese. The practice of routine referral for this indication deserves further evaluation.},
DOI = {10.1111/chd.12584}
}