Echocardiography Aids Fetus with Heart Defect

Conducted by researchers at The Children's Hospital of Philadelphia (PA, USA), the study was published in the June 2001 issue of Pediatrics.

Fetal echocardiography is increasingly used to detect congenital heart defects before birth, although whether prenatal diagnosis benefits children with heart disease has been questioned. The new study showed that the prenatal detection allowed better treatment, such as delivering the baby at a hospital with an advanced high-risk nursery and promptly administering the drug prostaglandin to maintain blood flow until the first stage of reconstructive surgery can be performed. Compared to newborns with HLHS diagnosed after birth, infants diagnosed prenatally were half as likely to experience seizure or coma prior to or within six weeks of their surgery.

The researchers studied 216 newborns with HLHS, 79 of whom were diagnosed prenatally. They found survival rates after the first stage of surgery to be the same, 74%, regardless of whether HLHS was diagnosed before or after birth. Since the period of that study, survival rates have continued to improve. At Children's Hospital, 86% of infants with HLHS survived the first stage of surgery from January 1999-April 2000. However, children with HLHS remain at a higher risk of long-term cognitive and neurologic problems compared to children with other heart defects.

"We hope to show that prenatal diagnosis, in addition to reducing short-term neurologic problems, also improves long-term functioning,” said William T. Mahle, M.D., a cardiologist at the hospital and lead author of the study. "We will follow the children in the study as they attain school age to assess how well they're doing cognitively and neurologically.”




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