Objectives: to analyse the outcome of fetuses with congenital heart disease (CHD) in the period 2000-2005 in comparison to the data of a multicentre study regarding the previous era.
Methods: Data of 7 centres operating in prenatal echocardiographic diagnosis were prospectively collected and analyzed; the inclusion criteria being a confirmed fetal diagnosis after birth or at autopsy and a known follow-up, for at least 6 months after birth.
Results: Data of 661 fetuses satisfied the inclusion criteria. Age at diagnosis varied between 15 and 37 weeks’gestation, median 24. Chromosomal and extracardiac anomalies were associated in 67 and 60 cases respectively (10.1% and 9.1%).
Outcome: Hundred forty cases opted for the termination of pregnancy (21.2%) versus the previous figure of 28.9%. Five hundred twenty one fetuses continued pregnancy, 23 of them died in utero (4.4%).
A total of 109/521 (21%) died postnatally, postoperative death occurred in 58/285 (20.4.%) versus previous total deaths in 43% and postoperative ones in 38%. Surgical mortality was highest in cases with hypoplastic left heart and Ebstein’s anomaly. The mortality rate was higher in presence of associated chromosomal or extracardiac anomalies (40% and 31% respectively versus 15.6% isolated CHD). A total of 389/521 (74.7%) infants survived versus previous 45%. Recurrence of CHD was 6%.
Conclusions: Our data show an improved outcome of cases with prenatal diagnosis of CHD both as for the total and surgical mortality.These data reflect an improved perinatal management and improved results of cardiosurgery in the treatment of neonates with congenital heart lesions.