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KEY POINTS * Prenatal diagnosis of congenital heart disease (CHD) is important for investigation of affected fetuses for comorbidities, prognostication, preparation for postnatal management,

and parental choice about continuation of pregnancy * Historical risk factors, such as a family history of CHD, or fetal risk factors, including increased nuchal translucency, warrant

investigation with detailed fetal echocardiography * Most fetuses with CHD present in the 'low-risk' population, and prenatal detection depends on recognizing abnormalities during

obstetric scans * Cardiac anomalies characterized by an abnormal four-chamber view of the heart have a higher detection rate than those in which the abnormality is primarily of the outflow

tracts * For particular cardiac lesions, including transposition of the great arteries, coarctation of the aorta, and hypoplastic left heart syndrome, prenatal diagnosis improves outcomes *

Prenatal diagnosis of CHD allows the preparation of postnatal intervention in most instances; in a minority of cases (mainly critical left-heart lesions), fetal cardiac intervention can be

considered ABSTRACT Congenital heart defects can be diagnosed during fetal life using echocardiography. Prenatal diagnosis allows full investigation of affected fetuses for coexisting

abnormalities, and gives time for parents to be informed about the prognosis of the fetus and treatments that might be required. In a minority of cases, where the natural history suggests an

unfavourable outcome, prenatal diagnosis provides an opportunity for fetal cardiac intervention. For some cardiac lesions, notably hypoplastic left heart syndrome, transposition of the

great arteries, and coarctation of the aorta, prenatal diagnosis has been shown to reduce postnatal morbidity and mortality. Some costs of care, notably the transport of critically ill

infants, are reduced by prenatal diagnosis. Prenatal screening programmes typically recommend detailed assessment of fetuses judged to be at high risk of congenital heart disease. However,

most cases of congenital heart disease arise in the low-risk population, and detection of affected fetuses in this setting depends on recognizing abnormalities of the heart during the

midtrimester scan. Evidence supports the use of structured training interventions and feedback to those undertaking sonographic examinations, to improve the prenatal detection of congenital

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Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS DETECTION OF CONGENITAL HEART DISEASE BY NEONATOLOGIST PERFORMED CARDIAC ULTRASOUND IN PRETERM INFANTS Article Open access 23

July 2024 ADVANCING FETAL DIAGNOSIS AND PROGNOSTICATION USING COMPREHENSIVE PRENATAL PHENOTYPING AND GENETIC TESTING Article 27 June 2024 MATERNAL AND NEONATAL FACTORS ASSOCIATED WITH

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the fetal heart. _Semin. Fetal Neonatal Med._ 18, 286–297 (2013). Article  PubMed  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Congenital

Heart Disease, Fetal Cardiology Unit, Evelina London Children's Hospital, London, SE1 7EH, UK Lindsey E. Hunter & John M. Simpson Authors * Lindsey E. Hunter View author

publications You can also search for this author inPubMed Google Scholar * John M. Simpson View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS

Both authors researched data for the article, contributed substantially to discussion of its content, wrote the manuscript, and reviewed and edited it before submission. CORRESPONDING AUTHOR

Correspondence to John M. Simpson. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing financial interests. POWERPOINT SLIDES POWERPOINT SLIDE FOR FIG. 1 POWERPOINT

SLIDE FOR FIG. 2 POWERPOINT SLIDE FOR TABLE 1 RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hunter, L., Simpson, J. Prenatal screening for structural

congenital heart disease. _Nat Rev Cardiol_ 11, 323–334 (2014). https://doi.org/10.1038/nrcardio.2014.34 Download citation * Published: 25 March 2014 * Issue Date: June 2014 * DOI:

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