Screening for congenital heart disease prior to fetal surgery

Guevara E.G.; Guerra I.V.; Acosta J.M. · Revista Peruana de Ginecologia y Obstetricia (2024) · DOI: 10.31403/rpgo.v70i2608

Resumen

Congenital cardiopathies are the most frequent malformations and represent a high neonatal morbidity and mortality rate, especially in those neonates without timely prenatal diagnosis. They appear as the first cause of infant death associated with congenital malformations. Advances in technology and the standardization of ultrasound diagnostic protocols have allowed increasingly accurate identification of congenital heart diseases. However, this has not been sufficient and there continues to be a high rate of neonates with congenital heart disease undiagnosed in prenatal surveillance. On the other hand, with the advent of fetal surgery, it is necessary to identify the presence of any major congenital heart disease that could cloud the prognosis associated with the underlying fetal pathology that made intrauterine intervention necessary. Considering the above, both parents and medical professionals need to be made aware of the importance of screening for congenital heart disease, especially in those fetuses that are going to undergo prenatal surgery. There is currently a high rate of errors in congenital heart disease screening, which causes anxiety in parents. This may be due to inadequate imaging technique, lack of standardization in the study protocol based on clinical practice guidelines, or lack of adequate training to perform this type of study. This article focuses on the most common errors in screening for congenital heart disease during second trimester morphological ultrasound, based on clinical practice guidelines for fetal echocardiography.