Review article
FETAL CARDIAC SCREENING IN PROTECTION FROM PERINATAL MORTALITY AND MORBIDITY – THE NEW, VERY IMPORTANT ROLE OF FETAL ECHOCARDIOGRAPHY IN OBSTETRICS AND PEDIATRIC CARDIOLOGY
IVAN MALČIĆ
orcid.org/0000-0002-1060-0988
; Zagreb University Hospital Centre, Department of Pediatrics, Division of Pediatric Cardiology, Zagreb, Croatia
LIDIJA SRKOČ MAJČICA
; Zabok General Hospital and Croatian Veterans Hospital, Department of Pediatrics, Zabok, Croatia
BERIVOJ MIŠKOVIĆ
; Sveti Duh University Hospital, Department of Obstetrics and Gynecology, Zagreb, Croatia
Abstract
Objective: The main objective of this review is to highlight the value of fetal cardiac screening in the protection from
perinatal morbidity and mortality by respecting modern scientifi c, diagnostic and therapeutic possibilities. Indications
for fetal cardiac screening according to the level of risk are highlighted, both tabularly and in an extensive discussion
that takes into account teamwork and interprets fi ndings by taking into account Class of Recommendation (COR) and evidence-based patient discussions, Level of Evidence (LOE). Methods and results are derived from studying the guidelines of the American Heart Association (AHA), Association of European Pediatric Cardiology (AEPC), International Society of Ultrasound in Obstetrics and Gynecology (ISOUG), and other extensive recent literature. The aim is to highlight the interests of fetal cardiac medicine, including the diagnosis of congenital heart disease (CHD) and arrhythmias, assessment of fetal cardiovascular function and available methods of intrauterine treatment, as well as of immediate or early postnatal intervention. Extensive discussion with numerous literature citations and tabular presentation highlights the referral indications for fetal cardiac screening (FCS), factors that increase the risk of CHD and other heart diseases (arrhythmias and cardiomyopathies), and a population overview of extracardiac abnormalities associated with heart diseases. Along with the inevitable tables, the text is accompanied by several important drawings or echocardiographic representations that in their own way permeate the joint fi ndings of obstetricians and pediatric cardiologists-fetologists. Research confi rming that the application and consideration of fetal cardiac screening has a positive effect on reducing perinatal morbidity and mortality, especially in the case of complex heart defects, is presented at the end. Conclusion: In the last 20 years, fetal cardiac medicine has advanced so much in diagnostic and therapeutic terms that it signifi cantly affects overall perinatal morbidity and mortality, especially because CHDs are the most common congenital anomalies. Accurate cardiac fetal diagnosis, increasing therapeutic approaches to the fetal heart, both medical and interventional, and dynamic development of new technologies have brought fetal cardiac medicine to a level without which modern medicine in any country can no longer be imagined.
Keywords
cardiology; pediatric; fetus; fetal echocardiography; congenital heart disease; perinatal morbidity and mortality
Hrčak ID:
259264
URI
Publication date:
19.6.2021.
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