Dhanardhono T, Thia EW, Wei X, Saktini F,
Dewi PK, Yeo GS
Correspondence: Dr George SH Yeo, dr.george.sh.yeo@gmail.com
ABSTRACT
Introduction Congenital heart defect (CHD) is
a significant cause of neonatal and infant mortality. We aimed to evaluate the
incidence and pregnancy outcome of foetuses diagnosed with chromosomally normal
CHD in KK Women’s and Children’s Hospital (KKH), Singapore, in 2008–2009.
Methods We reviewed the medical records of
pregnant women who underwent first trimester screening and were diagnosed with
foetal CHD at KKH. Additional information was obtained from the Birth Defect
Registry for the period 2008–2009. Foetuses with abnormal karyotype or minor
lesions not expected to be detected by ultrasonography were excluded.
Results 38 out of 9,834 euploid foetuses were
diagnosed with CHD. Major defects were found in 26 (68%) foetuses, while 12
(32%) had minor CHDs. Tetralogy of Fallot, atrioventricular septal defect,
hypoplastic left heart syndrome, transposition of the great arteries and
ventricular septal defect constituted the five most common major CHDs observed.
In 14 (54%) foetuses with prenatally diagnosed major CHD, the outcome was
termination of pregnancy, while 12 (46%) pregnancies continued to birth.
Among the live-born babies with major CHD, eight
(67%) underwent surgery.
Conclusion The incidence of non-chromosomal
major CHD in Singapore was about 2.6 per 1,000 foetuses. A detection rate of
88.5% was achieved for major CHD during the study period. Advances in CHD
management have thrown up new challenges for clinicians in the area of
diagnosis, treatment and ethics. Therefore, it may be beneficial to constitute
a regulatory entity as a fundamental guide to improve the future management of
foetuses diagnosed with CHD.
Keywords:
congenital heart defects, incidence, outcome, prenatal diagnosis,
ultrasonography
Singapore Med J 2012; 53(10): 643–647
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