The fast technical development enables the examination of the foetal heart malformations and the functional abnormalities in the particularly high risk pregnancies as early as on the 14th gestational week. Good diagnostic and prognostic accuracy make early foetal echocardiography a routine procedure today. The early diagnosis gives a choice for parents to continue or to interrupt the pregnancy. In the high risk pregnancies the optimal time of the special foetal echocardiography is between the 18th-22nd gestational weeks. In cases of severe cardiac malformations the interruption of the pregnancy on parental request is possible before the 22nd, in special cases maximum 24th gestational week. If the parents decide to continue the pregnancy, or if the diagnosis was established after the 22nd gestational week, a well organised perinatal management is very important. The prenatal diagnosis and good perinatal management improves the prognosis of the transposition of great arteries and the aortic coarctation. In cases of hypoplastic left heart syndrome the duration of stay at the intensive care unit was found to be shorter and the long term neurological outcome to be better in the prenatally diagnosed group. The treatment of foetal arrhythmias is based on protocols and the survival improved significantly. The results of foetal balloon dilation of severe aortic or pulmonary stenosis to prevent the progression to hypoplastic left or right heart syndrome are better, the rate of the foetal technically successful cases is 60%, the clinically successful cases is 10%. Prenatal enlargement of the foramen ovale with laser seems an appropriate method to prevent the development of pulmonary hypertension, which has a prave influence on survival, in patients with hypoplastic left heart syndrome. The continuous training and quality control of sonographers performing the prenatal screening could improve the prenatal detection rate of congenital heart malformations.
|Number of pages||12|
|Publication status||Published - Dec 1 2009|
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