Comparison of prenatal ultrasound and postmortem findings in fetuses and infants with congenital heart defects

Authors

  • Dr C. V. Isaksen,

    Corresponding author
    1. Institute of Morphology and Department of Pathology, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
    2. National Center for Fetal Medicine, Department of Obstetrics and Gynecology, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
    • Department of Pathology, Trondheim University Hospital, 7006 Trondheim, Norway
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  • S. H. Eik-Nes,

    1. National Center for Fetal Medicine, Department of Obstetrics and Gynecology, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
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  • H.-G. Blaas,

    1. National Center for Fetal Medicine, Department of Obstetrics and Gynecology, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
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  • E. Tegnander,

    1. National Center for Fetal Medicine, Department of Obstetrics and Gynecology, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
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  • S. H. Torp

    1. Institute of Morphology and Department of Pathology, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
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Abstract

Objective

Detection of congenital heart defects by prenatal ultrasound examination has been one of the great challenges since the investigation for fetal anomalies became part of the routine fetal examination. This prospective study was designed to evaluate the concordance of prenatal ultrasound findings with autopsy examination in a population consisting of both referred women and non-selected pregnant women.

Design

Criteria for inclusion were an ultrasound examination at the National Center for Fetal Medicine and an autopsy performed during the years 1985–94. Results from the ultrasound and autopsy examinations were systematized into categories depending on the degree of concordance.

Results

Of 408 infants and fetuses with developmental anomalies, 106 (26%) had congenital heart defects. In 63 (59%) of these 106 cases, the heart defect was the principal reason for the termination of pregnancy or the cause of death. Excluding five cases with a secundum atrial septal defect, there was complete agreement between the ultrasound examination and the autopsy findings in 74 (73%) of 101 cases. In 18 cases, there were minor discrepancies between ultrasound and autopsy findings. The main diagnosis was thus correct in 92 cases (91%). From the first time period (1985–89) to the second (1990–94), the detection rate of all heart defects increased from 48% to 82%.

Conclusion

This study confirms a good correlation between ultrasound and autopsy diagnoses in fetuses and infants with congenital heart defects. A significant improvement in the detection of heart defects occurred from the first time period to the second and was probably due to increased experience and technical advances. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology

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