Validação da importância dos critérios de referenciação propostos pela direcção geral de saúde para realização de ecocardiografia fetal.

Abstract

Congenital heart disease is the most frequent congenital malformation, affecting about 5-8 newborn per thousand live births. Nowadays it is possible to do prenatal diagnosis of these conditions with fetal echocardiography (EcoF) but because health resources are limited this exam must be ordered according to the criteria established by the Portuguese Health Department.Evaluate the importance of the referral criteria for fetal echocardiography attending to the cardiac anomalies identified. To determine prevalence and mortality rates in fetus with cardiac anomalies.Retrospective analysis of the clinical records of 733 fetus to which was performed EcoF in the Prenatal Cardiology consultation of a tertiary center of Pediatric Cardiology, between 2006 and 2008. Were registered demographic data, referral motif, EcoF results and follow-up data. The referral motif was classified in two groups: (I) The "Risk Group"--which referral was consistent with the Health department indications and this included major causes (family, maternal, fetal) and minor causes (other situations), and the "No risk Group" (II)--which referral wasn't consistent with those indications.During this period were performed 871 fetal echocardiograms to 705 pregnant women. The median maternal age was 32 years (15-45 years) and mean gestational age was 26 weeks (± 4 wk). The "Risk group" included 89.5% of the sample. Were identified 52 cases (7%) with cardiac anomalies in fetal echocardiography: 42 structural anomalies, 8 rhythm anomalies and 2 pericardial effusions. These abnormalities were distributed as follows: "Risk Group"--family cause (3), maternal cause (3), fetal cause (39), minor cause (5) and "No Risk Group" (2). The "Risk Group" had more cardiac abnormalities (6.8% vs 0.3%) (p>0.05), specially the "fetal cause subgroup" (p