Long-term experience with the prenatal diagnosis of cardiac anomalies in high-risk pregnancies in a tertiary center.

Background: The aim of this study was to analyze the role of the prenatal diagnosis of cardiac anomalies in our center.
Methods: The data of 5540 pregnant women at risk for congenital heart disease and studied at fetal echocardiography between 1984 and 2002, with complete follow-up were retrospectively analyzed.
Results: There was a progressive gradual increase in the number of cases examined per year; 670 fetuses (12% of the population) had congenital heart disease, 6.3% of the milder lesions were not detected. A cardiac arrhythmia was diagnosed in 284 fetuses. Extracardiac and chromosomal anomalies were associated in 23.7 and 14.6% respectively. Recurrence of congenital heart disease was 4.1%. One hundred and seventy-four patients (26%) opted for pregnancy termination; of the 496 fetuses whose parents decided to continue with pregnancy, 10.1% died in utero, 33.7% postnatally and 56.2% survived. The post-surgical mortality was 30.4%. Negative prognostic factors were associated anomalies, heart failure and complex congenital heart disease. Twenty-nine out of 33 fetuses with persistent tachyarrhythmias treated in utero survived; fetuses with complex and isolated atrioventricular block had a 75 and 11.1% mortality.
Conclusions: Prenatal diagnosis was useful in the management of pregnancy and a planned birth and was life-saving in case of tachyarrhythmia.