Impact of prenatal diagnosis and outcomes for congenital heart disease in two centers – comparative study

Session

Medicine and Nursing

Description

Congenital heart disease (CHD) are the most common form of birth defects with the incidence of about 8 to 10 per 1000 (0.8%–1%) live-born. Prenatal identification and management of CHD are important because they are a leading cause of neonatal and infant death in development countries.

Aim of presentation: Here we present result of prenatal diagnosis using fetal echocardiography (FE) in two centers Genoa, Italy and Prishtina, Kosovo, comparing sensitivity and specifity of prenatal diagnosis, age of pregnancies and outcomes of fetuses with CHD.

Methods Retrospectively we analyzed medical records of 121 pregnancies in Prishtina and 68 in Genoa. Gestational age at the moment of diagnosis, type of CHD and outcomes of fetuses with CHD

Results: During the period January 2018 - December 2019, 205 fetuses out of 187 pregnancies were examined (14 gemelar pregnancies, two triplets). Out of 187 pregnant women, 68 were examined in Genoa (Italy), at the Health Institution "Istituto Giannina Gaslini" in Genoa, Italy, all with unique fetuses, while others were examined in Prishtina. Most of the examinations in Prishtina were performed at the Polyclinic "ECHO-SCAN". A small number of examinations were performed at the Main Family Medicine Center in Prishtina. A total of 342 fetal echocardiograms were performed. Each fetus was examined 1- 4 times (average 1.6 ± 0.6 times). The first examination was performed between the 14th and 38th week of pregnancy (average at 25.9 ± 9.2 weeks).

The average age of pregnant women in the group from Genoa was significantly higher (38.6 +/- 7.2 vs. 29.6 +/- 6.0, p <0.001) than in Kosovo.

Fetal echocardiography, as a method for early diagnosis of fetal CHD, has been shown to be a method with high diagnostic efficiency, respectively with sensitivity 90% and specificity 97.3%, with positive predictive value (PPV) 90%, respectively negative predictive value (NPV) 97.3%.

According to the centers, in Genoa group:

- the degree of sensitivity of the FE for the diagnosis of CHD was 91.67%,

- the degree of specificity was 96.43%, VPP 84.62%, respectively VPN 98.18%.

In Prishtina group:

- the degree of sensitivity of FE for the diagnosis of CHD was 89.29%,

the degree of specificity was 97.83%, VPP of 92.59%, respectively NPV of 96.77%

Conclusion: Fetal echocardiography (EF) is a safe and highly informative method, invaluable in the assessment and diagnosis of CHD. The sensitivity of FE in the group of fetuses studied was 91.67% and the specificity was 96.43%. The positive predictive value was 84.62% while the negative value was 98.18%. The results of this study are closely correlated with data from the cited literature.

Keywords:

fetal echocardiography, congenital heart disease, fetal screening, hidrops fetalis

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-550-47-5

Location

UBT Kampus, Lipjan

Start Date

30-10-2021 12:00 AM

End Date

30-10-2021 12:00 AM

DOI

10.33107/ubt-ic.2021.199

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Oct 30th, 12:00 AM Oct 30th, 12:00 AM

Impact of prenatal diagnosis and outcomes for congenital heart disease in two centers – comparative study

UBT Kampus, Lipjan

Congenital heart disease (CHD) are the most common form of birth defects with the incidence of about 8 to 10 per 1000 (0.8%–1%) live-born. Prenatal identification and management of CHD are important because they are a leading cause of neonatal and infant death in development countries.

Aim of presentation: Here we present result of prenatal diagnosis using fetal echocardiography (FE) in two centers Genoa, Italy and Prishtina, Kosovo, comparing sensitivity and specifity of prenatal diagnosis, age of pregnancies and outcomes of fetuses with CHD.

Methods Retrospectively we analyzed medical records of 121 pregnancies in Prishtina and 68 in Genoa. Gestational age at the moment of diagnosis, type of CHD and outcomes of fetuses with CHD

Results: During the period January 2018 - December 2019, 205 fetuses out of 187 pregnancies were examined (14 gemelar pregnancies, two triplets). Out of 187 pregnant women, 68 were examined in Genoa (Italy), at the Health Institution "Istituto Giannina Gaslini" in Genoa, Italy, all with unique fetuses, while others were examined in Prishtina. Most of the examinations in Prishtina were performed at the Polyclinic "ECHO-SCAN". A small number of examinations were performed at the Main Family Medicine Center in Prishtina. A total of 342 fetal echocardiograms were performed. Each fetus was examined 1- 4 times (average 1.6 ± 0.6 times). The first examination was performed between the 14th and 38th week of pregnancy (average at 25.9 ± 9.2 weeks).

The average age of pregnant women in the group from Genoa was significantly higher (38.6 +/- 7.2 vs. 29.6 +/- 6.0, p <0.001) than in Kosovo.

Fetal echocardiography, as a method for early diagnosis of fetal CHD, has been shown to be a method with high diagnostic efficiency, respectively with sensitivity 90% and specificity 97.3%, with positive predictive value (PPV) 90%, respectively negative predictive value (NPV) 97.3%.

According to the centers, in Genoa group:

- the degree of sensitivity of the FE for the diagnosis of CHD was 91.67%,

- the degree of specificity was 96.43%, VPP 84.62%, respectively VPN 98.18%.

In Prishtina group:

- the degree of sensitivity of FE for the diagnosis of CHD was 89.29%,

the degree of specificity was 97.83%, VPP of 92.59%, respectively NPV of 96.77%

Conclusion: Fetal echocardiography (EF) is a safe and highly informative method, invaluable in the assessment and diagnosis of CHD. The sensitivity of FE in the group of fetuses studied was 91.67% and the specificity was 96.43%. The positive predictive value was 84.62% while the negative value was 98.18%. The results of this study are closely correlated with data from the cited literature.