Risk factors in the medical history of pregnant women undergoing congenital heart defect prenatal screening

Česká verzia

Authors: J. Pavlíček ¹; T. Gruszka ¹; L. Jabůrek ²
Authors place of work: Oddělení dětské a prenatální kardiologie FN Ostrava, primář MUDr. T. Gruszka ¹; Porodnicko-gynekologická klinika FN a LF UP Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. ²
Published in the journal: Ceska Gynekol 2011; 76(5): 386-392

Summary

Aims:
Evaluation of the congenital heart defects (CHDs) incidence and their prenatal detection rate in the Moravian-Silesian region. Presentation of fetal echocardiography as a screening method. Investigation of the relationship between risk factor and congenital heart defects.

Methodology:
Long-term study between 1999–2009. Overall evaluation of CHDs incidence and their follow-up and analysis of their link to possible risk factors. The data were collected from medical notes of the gynecologist and pediatric cardiologist in the region. Fetal echocardiography was performed as a primary screening during the second term of pregnancy. A number of 22 43 pregnant women were included in the study. When any pregnancy pathology detected, more detailed examination followed (extracardial diseases, chromosomal aberrations).

Results:
In the observed period, there were a total of 453 significant CHD (3.55/1000 births). In prenatal phase 208 CHDs (45.9%) were diagnosed. At least one risk factor was mentioned in 15.9 % of the screened families. When compared with the group without and with any risk factor, the difference is significant (χ²=7.28, p<0.0001). Mothers younger than 35 were compared with those aged 35 and older and the difference in values was not significant. However, generally, the probability of CHDs grow with age (GLM, z=2.468, p=0.013).

Conclusions:
Prenatal detection of CHDs has the highest success rate as a rutine screening method during the second trimester of pregnancy. We confirmed the existence of a higher occurrence of the CHD in the group of pregnant women with a history of risk factors in comparison with the group without such a history. The risk families should be offered a detailed examination by paediatric cardiologist skilled in fetal echocardiography. Heart defects are the most common morphology anomalies, mostly occuring as an isolated issue.

Key words:
congenital heart defect, fetal echocardiography, risk factor.

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