Organisation of Screening for Congenital Heart Disease

Prenatal diagnosis of congenital heart disease is associated with improved survival and reduced morbidity for some forms of critical congenital heart disease (CHD). Most population screening is based on detection of affected fetuses by incorporation of cardiac views in the midtrimester anomaly scan. This is further refined by first trimester screening by methods such as nuchal translucency (NT) thickness to detect fetuses at high risk for CHD who then undergo more detailed assessment. Pregnancies with historic or maternal risk factors CHD such as family history of CHD or maternal diabetes mellitus are typically offered specialist fetal echocardiography rather than relying solely on the midtrimester anomaly scan. Published recommendations have established not only cardiac referral indications but also optimal screening views with a relatively high degree of consistency between published standards. Following a prenatal diagnosis of CHD, a multidisciplinary team is required to provide appropriate diagnostic and prognostic information, investigation for associated abnormalities, parental support and co-ordination of care pathways.