The impact of early diagnosis of fetal cardiac abnormalities on the postnatal outcome has been controversial in literature. We aimed to evaluate the role of fetal echocardiography (FE) as a diagnostic tool for early detection and proper management of fetal cardiac abnormalities, study the indications of referral and detect the perinatal outcome in our institution. This is a cross-sectional observational and descriptive study that included one hundred and one singleton pregnant women (101 fetuses) who were referred for FE over a period of one year. Indications for referral and perinatal risk factors were documented. FE and postnatal transthoracic echocardiography were done. Fetal cardiac abnormalities were detected in 46.5% of cases. Congenital heart defects (CHDs) in 34.6%, fetal arrythmias in 9.9%, cardiomyopathy in 2.9% and cardiac mass (Rhabdomyoma) in 1% (combined structural and rhythm abnormalities were observed in two fetuses). Of the CHDs, complex heart lesions were diagnosed in 57.1%, common atrioventricular canal in 28.6% and conotrunchal anomalies in 14.3%. Of the ten cases with fetal arrythmias, five fetuses had tachyarrhythmias, four had ectopics and one fetus had congenital heart block in association with maternal lupus. The indications for referral were abnormal obstetric ultrasound (52.5%), maternal medical illnesses (23.8%), multiple neonatal deaths (13.9%) and positive family history of CHD (10.9%). The number of fetuses with cardiac abnormalities was significantly higher than those without cardiac abnormalities in mothers not exposed to perinatal risk factors (p = 0.009) and was statistically lower in mothers exposed to perinatal risk factors (p = 0.005). FE showed 100% accuracy in diagnosing complex lesions, common atrio-ventricular canals, cono-truncal anomalies, cardiac masses and fetal arrhythmias. It missed two cases of tiny muscular ventricular septal defects and one case of aortic coarctation. Cases of fetal supraventricular tachycardia were successfully treated in-utero. CHDs exist in fetuses with no underlying perinatal risk factors. FE can accurately diagnose most of the cardiac anomalies though few errors remain challenging (aortic coarctation). It also offers a good chance for successful early life-saving management of some types of fetal arrhythmia.

中文翻译：

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胎儿超声心动图的临床应用：埃及中心的经验

胎儿心脏异常的早期诊断对产后结果的影响在文献中一直存在争议。我们旨在评估胎儿超声心动图 (FE) 作为早期检测和正确管理胎儿心脏异常的诊断工具的作用，研究转诊指征并检测我们机构的围产期结局。这是一项横断面观察性和描述性研究，其中包括 101 名单胎孕妇（101 个胎儿），她们在一年内接受 FE 治疗。记录转诊指征和围产期危险因素。FE 和产后经胸超声心动图已完成。在 46.5% 的病例中检测到胎儿心脏异常。先天性心脏病 (CHD) 占 34.6%，胎儿心律失常占 9.9%，心肌病占 2。9% 和心脏质量（横纹肌瘤）为 1%（在两个胎儿中观察到结构和节律组合异常）。在先天性心脏病中，57.1% 诊断为复杂心脏病变，28.6% 诊断为房室常见病变，14.3% 诊断为鼻鼻管异常。在 10 例胎儿心律失常病例中，5 例胎儿出现快速性心律失常，4 例出现异位心律失常，1 例胎儿出现与母体狼疮相关的先天性心脏传导阻滞。转诊指征为产科超声异常（52.5%）、孕产妇疾病（23.8%）、多胎新生儿死亡（13.9%）和CHD阳性家族史（10.9%）。在未暴露于围产期危险因素的母亲中，心脏异常胎儿的数量显着高于没有心脏异常的胎儿（p = 0. 009），并且在暴露于围产期危险因素的母亲中更低（p = 0.005）。FE 在诊断复杂病变、常见房室管、锥体干异常、心脏肿块和胎儿心律失常方面的准确性为 100%。它漏掉了 2 例微小肌性室间隔缺损和 1 例主动脉缩窄。胎儿室上性心动过速病例在子宫内成功治疗。CHD 存在于没有潜在围产期危险因素的胎儿中。FE 可以准确诊断大多数心脏异常，尽管很少有错误仍然具有挑战性（主动脉缩窄）。它还为某些类型的胎儿心律失常的早期挽救生命的成功管理提供了很好的机会。心脏肿块和胎儿心律失常。它漏掉了 2 例微小肌性室间隔缺损和 1 例主动脉缩窄。胎儿室上性心动过速病例在子宫内成功治疗。CHD 存在于没有潜在围产期危险因素的胎儿中。FE 可以准确诊断大多数心脏异常，尽管很少有错误仍然具有挑战性（主动脉缩窄）。它还为某些类型的胎儿心律失常的早期挽救生命的成功管理提供了很好的机会。心脏肿块和胎儿心律失常。它漏掉了 2 例微小肌性室间隔缺损和 1 例主动脉缩窄。胎儿室上性心动过速病例在子宫内成功治疗。CHD 存在于没有潜在围产期危险因素的胎儿中。FE 可以准确诊断大多数心脏异常，尽管很少有错误仍然具有挑战性（主动脉缩窄）。它还为某些类型的胎儿心律失常的早期挽救生命的成功管理提供了很好的机会。FE 可以准确诊断大多数心脏异常，尽管很少有错误仍然具有挑战性（主动脉缩窄）。它还为某些类型的胎儿心律失常的早期挽救生命的成功管理提供了很好的机会。FE 可以准确诊断大多数心脏异常，尽管很少有错误仍然具有挑战性（主动脉缩窄）。它还为某些类型的胎儿心律失常的早期挽救生命的成功管理提供了很好的机会。