Background

Major Congenital Heart Disease (CHD) occurs in about 35/10,000 births.Despite advances in screening programme,up to 50% of major congenital heart diseases were still missed on fetal anomaly scans in UK.

Objectives

To identify missed cases of major congenital heart disease¹ which require immediate cardiac assessment and/or treatment within the first two weeks of a child’s life.

Methods

Babies born from 1^st January 2014- 31^st Dec 2018 who were diagnosed with CHD were identified from local neonatal database. Cases with confirmed post-natal echocardiogram CHD were included and cases identified antenatally were excluded. Isolated cases of ASD and VSD were also excluded from analysis.

Results

48 babies with CHD were identified. 30 were missed on antenatal screening. Of them, 17 had major CHD needing surgical intervention. Out of 17, 11 had major cyanotic heart disease and 6 had major acyanotic heart disease.

Conclusion

Up to 35% of major congenital heart diseases were still missed on foetal anomaly scans in UK. This highlights importance of implementing newborn pulse oximetry screening in conjunction with Foetal Cardiac Screening Protocol to improve detection of major CHD.

References:

NHS Fetal Anomaly Screening Programme - Congenital Heart Disease. Version 2. Apr 2013.