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Trends in Prenatal Diagnosis of Critical Cardiac Defects in an Integrated Obstetric and Pediatric Cardiac Imaging Center

Journal of Perinatology volume 24, pages 674–678 (2004)Cite this article

Abstract

OBJECTIVE: Prenatal diagnosis of critical (requiring neonatal intervention) cardiac defects (critical congenital heart diseases (CCHD)) improves survival, yet detection of such malformations is poor. Our institution changed its practice and integrated a pediatric cardiologist into the perinatal team. The purpose of this study was to evaluate how this change affected the rate of detected congenital heart disease (CHD) and the diagnostic accuracy.

STUDY DESIGN: Obstetrical ultrasounds of mothers at high and normal risk for fetal CCHD at a single center between 1991 and 2001 were reviewed. Rate of detected CCHD, positive predictive values and false positives were compared before and after pediatric cardiology integration.

RESULTS: Between the first and second time periods, the rate of detected CCHD increased from 6.8/1000 ultrasounds to 12.9/1000 ultrasounds (p=0.007), and positive predictive value increased from 75 to 96%.

CONCLUSION: Collaboration with pediatric cardiology can significantly improve the rate of detected CCHD. These findings have significant implications for sonographer education and patient care.

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Acknowledgements

We wish to thank Karen Ralph and Colleen Uchman for manuscript preparation; Denise Angst, DNSc for her critical reviews of the manuscript; and the following physicians for their clinical involvement during the study: James Keller, MD, Bruce Pielet, MD, Brian McCulloch, MD, Thomas Iannucci, MD, Ira DuBrow, MD, Deborah Bryk-Seva, MD, and Peter Sodt, MD.

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Authors and Affiliations

  1. The Heart Institute for Children, Oak Lawn, IL, USA

    Bettina F Cuneo MD

  2. Departments of Obstetrics and Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, IL, USA

    Bettina F Cuneo MD

  3. Department of Obstetrics, Section of Maternal Fetal Medicine, Lutheran General Hospital, Park Ridge, IL, USA

    Letitia F Curran RDMS & Haim Elrad MD

  4. Advocate Health Care Office of Medical Education and Research, Park Ridge, IL, USA

    Nancy Davis MA

Authors
  1. Bettina F Cuneo MD
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  2. Letitia F Curran RDMS
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  3. Nancy Davis MA
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  4. Haim Elrad MD
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Presented in part at the Annual Scientific Session of the Society for Maternal – Fetal Medicine, January 2002.

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Cuneo, B., Curran, L., Davis, N. et al. Trends in Prenatal Diagnosis of Critical Cardiac Defects in an Integrated Obstetric and Pediatric Cardiac Imaging Center. J Perinatol 24, 674–678 (2004). https://doi.org/10.1038/sj.jp.7211168

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