Value of First and Early Second Trimester Fetal Echocardiography and Fetal Nuchal Translucency Measurement in Prediction of Fetal Congenital Heart Diseases

Background: Congenital heart anomalies have a significant effect on affected children's life with up to 25:35% mortality rate during pregnancy and the postnatal period, and 60% of this mortality occurs during the first year of life.

Objectives: To evaluate the value of fetal echocardiography and measuring of fetal nuchal translucency thickness in first and early second trimester in prediction of fetal congenital heart disease.

Methods: A prospective observational cohort study was conducted on 200 pregnant women attended to Tanta University Hospital, Department of Obstetrics and Gynecology at outpatient clinic or inpatient, the study took from January 2019 to December 2020. Patients underwent transabdominal fetal echocardiography at 10:16 weeks of gestation. transvaginal scan was also performed when needed. The first step in fetal cardiac ultrasound is to evaluate the orientation of the fetal laterality (presentation and lie). Establishing situs and atrial arrangement, Five short-axis views of heart. First view is acquired in abdomen at level of stomach to identify situs.

Results: predict congenital heart disease (compared to results of first Echo), nuchal translucency had 83.33% sensitivity, 98.97% specificity, 71.43% PPV, 98.50% NPV and 99.48% accuracy.. predict congenital heart disease (compared to fetal outcome), nuchal translucency had 83.33% sensitivity,98.97% specificity, 71.43% PPV, 99.48%% NPV and 98.50% accuracy.

Conclusions: Fetal echocardiography and measuring of fetal nuchal translucency thickness in first and early second trimester have good sensitivity in prediction and better specificity in exclusion of fetal congenital heart diseases.