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Should all cases of suspected fetal cardiac anomaly be referred to a specialist fetal cardiac service?
  1. K Linter1,
  2. J Marsh2,
  3. F Bu'Lock1,
  4. H Mousa3
  1. 1East Midlands Congenital Heart Centre, Leicester, UK
  2. 2Leicester Medical School, Leicester, UK
  3. 3Department of Fetal and Maternal Medicine, Leicester Royal Infirmary, Leicester, UK

Abstract

Introduction Prognosis for babies with prenatally diagnosed congenital heart disease varies widely according to precise cardiac diagnosis. There is a perception nationally that not all parents of babies with a prenatally diagnosed heart condition are referred to a fetal cardiologist. The impact of non-specialist counselling that parents receive to make decisions regarding their pregnancy is unknown.

Objectives To examine concordance between suspected fetal cardiac defects precipitating referral to our Fetal Cardiac Service with the findings of the detailed specialist fetal echocardiogram.

Methods Retrospective review of referrals to our tertiary fetal cardiac clinic between 2006 and 2008.

Results In 63 of the 163 referrals for suspected structural heart disease (mean gestational age 22 weeks) the suspected cardiac diagnosis was detailed in the referral. In those with a detailed referral diagnosis good correlation was observed in 68%, but there was a significant discrepancy in diagnosis in 21 cases (32%).

Conclusion We recommend in line with National Guidelines that all suspected fetal cardiac anomalies are referred promptly to a Specialist Fetal Cardiologist to avoid this worryingly high discrepancy in findings. Further work is required to evaluate the implication of counselling by non-specialist as compared to cardiology specialist on parents decisions.

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