FETAL ECHO AS AN ANTENATAL SCREENING TOOL IN LOW RISK WOMEN
Dr. Kalaiyarasi Umapathy MS(OG)* and Dr. N. Hephzibah Kirubamani
ABSTRACT
Around 2,40,000 children in India are born with CHD. Accurate prenatal diagnosis has potential to improve postnatal outcome. Fetal echo is highly specific for early detection of CHD. Aim of this study is to assess the Role of fetal Echo along with anomaly scan and to determine the prevalence of congenital heart disease with or without risk factors. Our study is Prospective Observational Study done at fetal medicine unit, Saveetha Medical College and Hospital from April 2020 to March 2021. 600 antenatal mothers recruited for fetal echo along with anomaly scan. Maternal (elderly gravida, Diabetes, with CHD, previous birth with CHD,1st degree relative with CHD, maternal autoimmune disorder, H/O drug intake) & fetal risk factors(raised NT, polyhydramnios, ascites, arrhythmias) analyzed, type of fetal cardiac defect noted postnatal follow up done. In our study the overall prevalence of CHD was 5.5%. Incidence of CHD in high risk mother 0.3% & low risk 5.17%. More than 50% CHD occurred in low risk maternal patients. Mean age women- 24.37yrs & mean GA fetus – 21+2wks. A total of 600 fetal echo were performed, 118-High risk mother & 482 low risk conventionally with CHD. Among high risk, TAPVC-2, Multiple membranous VSD-3, Double outlet RV with PS-1. Among low risk small 3mm VSD – 6, large VSD-4, VSD with aortic arch hypoplasia-1, TGA-2, Supraventricular Tachycardia for fetus-1, TOF-4, Ebsteins Anomaly-2, Common atria/TAPVC/TR-1, Asymmetrical cardiac chamber outflow tract-1, HLH-4, Situs-inversus wih Dextrocardia without any defect-1. Medical termination of pregnancy done for 7 cases (aortic arch hypoplasia-1, Common atria-1, HLH-4, Assymertical cardiac chamber-1), rest admitted in NICU and treated. Our study clearly reveals substantial proportion of CHD occurs in low risk women. Therefore, we recommend that atleast one detailed FE should be considered.
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