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Implementation of a statewide, multisite fetal tele-echocardiography program: evaluation of more than 1100 fetuses over 9 years

Journal of Perinatology volume 40, pages 1524–1530 (2020)Cite this article

Subjects

Abstract

Objectives

We sought to describe the implementation and effectiveness of a statewide fetal tele-echocardiography program serving a resource-limited population.

Study design

In 2009, our heart center established six satellite clinics for fetal tele-echocardiography around the state. We retrospectively reviewed all fetal tele-echocardiograms performed through 2018. Yearly statewide prenatal detection rates of operable congenital heart disease were queried from the Society of Thoracic Surgeons database.

Result

In 1164 fetuses, fetal tele-echocardiography identified all types of congenital heart disease, with a sensitivity of 74% and specificity of 97%. For the detection of ductal-dependent congenital heart disease, fetal tele-echocardiography was 100% sensitive and specific. Between 2009 and 2018, annual statewide prenatal detection rates of congenital heart disease requiring heart surgery in the first 6 months of life rose by 159% (17–44%; R2 = 0.88, p < 0.01).

Conclusions

The present study provides a framework for an effective, large-scale fetal tele-echocardiography program.

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Fig. 1: Locations of fetal cardiology telemedicine sites.
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Acknowledgements

We would like to thank Dr Beverly Spray for assistance with statistical support.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, AR, 72202, USA

    Elijah H. Bolin, Thomas H. Best, Dala Zakaria, Markus S. Renno, Lori L. Heil & Renee A. Bornemeier

  2. Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA, 94304, USA

    R. Thomas Collins II

  3. Division of Cardiology, Department of Pediatrics, University of Cincinnati and Cincinnati Children’s Hospital, Cincinnati, OH, 45229, USA

    Sean M. Lang

  4. Department of Anesthesia, University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, AR, 72202, USA

    Matthew G. Boushka

  5. Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, 72202, USA

    Curtis L. Lowery

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  1. Elijah H. Bolin
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Contributions

EHB conceived the study and composed the manuscript. RTC assisted in the composition of the manuscript. THB, DZ, SML, MGB, MSR, LLH, and CLL performed data collection and assisted in composing the manuscript. RAB conceived the study and helped to compose the manuscript.

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Correspondence to Elijah H. Bolin.

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Cite this article

Bolin, E.H., Collins, R.T., Best, T.H. et al. Implementation of a statewide, multisite fetal tele-echocardiography program: evaluation of more than 1100 fetuses over 9 years. J Perinatol 40, 1524–1530 (2020). https://doi.org/10.1038/s41372-020-0677-2

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