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Abstract 17195: Accuracy of Fetal Echocardiography in the Current Era


 Accuracy of Fetal Echocardiography in Defining Anatomical Details of Fetal Cardiac Pathology in the Current Era
 
 
 Background:
 Enhanced ultrasound technology and improvements in prenatal detection have provided opportunities to fine-tune fetal cardiac diagnoses. We sought to determine the accuracy of fetal echocardiography in defining anatomical details of major structural fetal heart disease(FHD)
 
 
 Methods:
 We queried the fetal echo database at the University of Alberta to identify pregnancies with a major FHD diagnosis between 2007-2018. We excluded simple septal defects, minor valve abnormalities and isolated coarctation. FHD was divided into 12 major categories to examine differences within subtypes. Fetal echocardiography reports were compared to post-natal echocardiography or autopsy when available, to assess segmental anatomy. Differences were described according to the following categories:1) No difference between fetal and postnatal findings 2) Minor differences with no impact on outcome (left superior vena cava), 3) Minor differences that could make a minor difference to the delivery plan or surgery (e.g. vascular ring), 4) Major differences that could lead to a change in the course of pregnancy, delivery or surgical planning (e.g. ductal dependency); 5) Errors of categorization that did not alter surgical planning but could have changed counseling (e.g. associations with extra-cardiac pathology).
 
 
 Results:
 In the study period 744 pregnancies with major FHD were encountered of which 151 (20.3%) had pregnancy termination, 43(6%) intrauterine demise, 6(1%) were lost to followup. 524(71%) were liveborn. Of the 744, 542 (524 echo and 18 autopsy) had confirmation of full cardiac anatomy. Table 1 details the number of cases in whom differences were demonstrated.
 
 
 Conclusion:
 Fetal echocardiography in the current era is highly accurate with few serious errors. Delineating the anatomy of the outflow tracts in complex cardiac lesions remains a challenge
 
 
 
