TY - JOUR
T1 - Referral indications for foetal echocardiography in a low resource setting
AU - Ladak, Asma
AU - Hoodbhoy, Zahra
AU - Mohsin, Shazia
AU - Ashiqali, Salima
AU - Malik, Saima
N1 - Publisher Copyright:
© 2021 Pakistan Medical Association. All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Objective: The aim of this study was to review primary indications for foetal echocardiography among pregnant women at a tertiary care center in a low resource setting. Methods: A retrospective record review was conducted of all women who have had a foetal echocardiogram between January 2015 and December 2016 at The Aga Khan University Hospital, Karachi, Pakistan. Information regarding maternal clinical characteristics, anomaly scan findings, indications for echocardiography and findings on foetal echocardiogram (FE) was collected. Results: The dataset included 1909 patients. Maternal comorbidities including maternal diabetes, (n=614, 47%) was the most common maternal indication, while multiple pregnancy (n=232, 38%) and intra-cardiac echogenic foci (n=168, 28%) was the most common foetal indication for referral. Major CHD was detected in 4.2% (n=81) of cases. In those with CHD, the most common indication for getting a FE was an abnormal 4-chamber (n=31, 38%) view on the screening obstetric ultrasound. Conclusions: Most of our patients were referred on the basis of indications that were not warranted based on international guidelines and very few had major CHD on FE. This emphasizes the need for justifying referrals for a resource intensive procedure such as FE.
AB - Objective: The aim of this study was to review primary indications for foetal echocardiography among pregnant women at a tertiary care center in a low resource setting. Methods: A retrospective record review was conducted of all women who have had a foetal echocardiogram between January 2015 and December 2016 at The Aga Khan University Hospital, Karachi, Pakistan. Information regarding maternal clinical characteristics, anomaly scan findings, indications for echocardiography and findings on foetal echocardiogram (FE) was collected. Results: The dataset included 1909 patients. Maternal comorbidities including maternal diabetes, (n=614, 47%) was the most common maternal indication, while multiple pregnancy (n=232, 38%) and intra-cardiac echogenic foci (n=168, 28%) was the most common foetal indication for referral. Major CHD was detected in 4.2% (n=81) of cases. In those with CHD, the most common indication for getting a FE was an abnormal 4-chamber (n=31, 38%) view on the screening obstetric ultrasound. Conclusions: Most of our patients were referred on the basis of indications that were not warranted based on international guidelines and very few had major CHD on FE. This emphasizes the need for justifying referrals for a resource intensive procedure such as FE.
KW - Congenital heart disease
KW - Foetal echocardiography
KW - Indications
KW - Low-resource setting
UR - http://www.scopus.com/inward/record.url?scp=85110277813&partnerID=8YFLogxK
U2 - 10.47391/JPMA.1255
DO - 10.47391/JPMA.1255
M3 - Article
C2 - 35157691
AN - SCOPUS:85110277813
SN - 0030-9982
VL - 71
SP - 390
EP - 394
JO - Journal of the Pakistan Medical Association
JF - Journal of the Pakistan Medical Association
IS - 1B
ER -