Structural heart disease in the fetus

Congenital heart defects can be diagnosed by ultrasound during fetal life with a high degree of diagnostic accuracy at specialist centers. Cardiac defects characterized by an abnormal four-chamber view of the heart have higher detection rates than those lesions which depend on views of the outflow tracts for their detection. Prenatal detection allows appropriate preparation for delivery and for the prenatal identification of associated anomalies. Prediction of babies who will require emergency postnatal intervention means that planning the site of delivery and emergency management is facilitated. There is evidence that postnatal outcome may be improved by prenatal diagnosis of some cardiac lesions including hypoplastic left heart syndrome, transposition of the great arteries, and coarctation of the aorta.