Prenatal diagnosis of congenital heart disease in an era of near-universal ultrasound screening: room for improvement.

摘要

In this issue of The Journal, Friedberg et al report the prenatal detection rate of major congenital heart defects (CHDs) among 3 major tertiary pediatric centers in northern California. For those who routinely diagnose and manage newborns with congenital heart disease, this study's results are not entirely unexpected; however, for those outside of the pediatric cardiac care community, they may be surprising. In the authors' study cohort, only 28% of major CHDs-lesions likely to present with congestive heart failure, low cardiac output, and/or hypoxemia in early infancy-were detected prenatally, despite near-uniform (99%) access to screening ultrasounds during the pregnancy. The question that follows is: If access to ultrasound screening is not the limiting factor, then why do we detect so little CHD prenatally?