Background Antenatal detection rates of major congenital heart disease (CHD) are still relatively low a cross the UK (approx. 23% in 1999 and are estimated to be around 30% in 2009, with widespread postcode variation). One problem has been the lack of a consistent and practical standard for fetal cardiac screening. The NHS Fetal Anomaly Screening Programme (FASP) has set a minimum standard of a 50% detection rate for major cardiac abnormalities.
Methods and materials Retrospective review of cases of CHD at Norfolk & Norwich University Hospital between 1st September 2006 until 30th September 2009 using ASTRAIA ultrasound database and Badger neonatal database.
Results During the study period, there were 59 cases of major cardiac abnormalities. Of these, 38 were detected antenatally. This gives an antenatal detection rate of 64%.
Out of the cases of antenatal ultrasound diagnosis of CHD: 19 opted for termination, 4 had an intrauterine death, and 15 were liveborn.
Our study has some shortcomings: it assumes that all undiagnosed cases were delivered here, and that they were entered onto the Badger database. It also assumes that our search of Astraia has detected all antenatally diagnosed cases.
Conclusion Our detection rate meets the new FASP national standards. However there is still scope for improvement.
A congenital abnormality register is recommended in order to accurately ascertain the detection rate of CHD. This register was started at NNUH in October 2011.
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