How Has Fetal Echocardiography Shaped the Practice of Pediatric Cardiology?

Abstract

Fetal echocardiography has enabled the diagnosis of structural cardiac malformations in utero. While certain cardiac conditions, in particular coarctation of the aorta and total anomalous pulmonary venous drainage, remain to be a challenge of prenatal diagnosis, a high degree of diagnostic accuracy can be expected for a large spectrum of congenital heart disease. The ability to diagnosis structural congenital cardiac malformation in utero has helped in the following regards: i) detection of associated extra-cardiac malformations and underlying syndromal abnormalities, ii) allow time for parents to better understand the nature of the cardiac lesions, discuss management options, and aware of the immediate- and long-term prognosis, iii) risk stratification with implications on perinatal and postnatal management, iv) potential improvement in the outcomes of the fetuses after delivery, and v) the potential to offer fetal interventions. Most of the available data to date have, however, been reported by developed countries and the ways in which paediatric cardiac practice have been shaped would be discussed. On the other hand, the impact of prenatal diagnosis in developing countries and its influence on the practice of paediatric cardiology is unclear and requires further studies for better understanding.