Behavioral analysis of the pre-natal diagnosis of congenital heart diseases. Matanzas. An 18 years study (1990-2007).

Abstract

Fetal echocardiography is the cornerstone of the congenital heart diseases pre-natal diagnosis, where it is necessary to determine exactly the disorder and its magnitude and them to define what to do with it. The objective of this work is to analyze the performing of congenital heart diseases pre-natal diagnosis in Matanzas and its repercussion on the decrease of infantile mortality. For that reason we made a comparative analysis from 1990 to 1998 and from 1999 to 2007, during which the program of congenital heart diseases prenatal diagnosis has been developed in the province. The following variables were related: total of children born alive, total of heart diseases diagnosed intra-uterus and total of children born with severe heart diseases (all of them summed up are the total of registered severe heart diseases), total of less-than-one-year-old children deceased and mortality rate (average) for that reason. The cases of fetal heart diseases are classified according to the reference motive and to the kind of practiced prenatal echocardiography, confirmed or corrected by necropsy, or after birth, in the cases of non-interrupted pregnancy, through transthoracic echocardiography. A total of 153 heart diseases were identified intrauterus, most of them (93) during the last period of pregnancy, representing 60,8 % of the total of the prenatal diagnosis, and also 53,1 % of the cases registered with those disorders in that period. Hipoplasia of the Left Cavities, Atriaventricular Septation Defects and Tetralogy of Fallot are detected in 48,4 % of the positive cases, and a heart disease suspicion is the remission cause of 63,4 % of the diagnosed cases. The increase of heart diseases prenatal diagnosis in the last period led to a decrease of infantile morbimortality by those diseases. Fetal cardiac or extra-cardiac ultrasonographic alterations, confirmed or suspected, increase the diagnostic probability of a heart disease in the fetus.