Congenital heart defects are among the most common congenital anomalies and cause significant perinatal morbidity and mortality. Prenatal detection allows counseling, multidisciplinary planning and optimization of delivery. This prospective observational cohort study will screen all pregnant women attending the Fetomaternal Unit, Women's Health Hospital, Assiut University for anomaly scan at 18+0 to 22+6 weeks gestation over 12 months. All cases with suspected or detected fetal cardiac anomalies will be consecutively recruited and followed antenatally until delivery and postnatally when possible. Primary outcome is frequency of fetal cardiac anomalies among screened fetuses. Secondary outcomes include frequency of each type of anomaly, NICU admission, need for neonatal cardiac surgery or intervention, and neonatal death. Data will be analyzed using SPSS with descriptive statistics and chi-square or Fisher exact test and t-test or Mann-Whitney as appropriate. P less than 0.05 is considered significant.
All eligible pregnant women attending the Fetomaternal Unit for second-trimester anomaly scanning will undergo standardized fetal anatomical and cardiac assessment including situs, cardiac position and axis, four-chamber view, outflow tracts, three-vessel view, three-vessel-trachea view when possible, and cardiac rhythm. Cases with suspected cardiac anomalies will undergo detailed documentation and fetal echocardiography when clinically indicated according to routine practice. They will be counseled and followed with assessment of fetal growth, cardiac function, hydrops and progression. Pregnancy outcomes including gestational age at delivery, mode of delivery, birth weight, Apgar scores, NICU admission, neonatal cardiac intervention and survival will be collected. Postnatal echocardiography will be recorded when available to confirm antenatal diagnosis. The study involves no experimental intervention.
Study Type
OBSERVATIONAL
Enrollment
200
Frequency of Fetal Cardiac Anomalies Detected at Anomaly Scan
Proportion of fetuses with cardiac anomalies among all fetuses undergoing anomaly screening at 18+0 to 22+6 weeks. Includes any structural abnormality of heart and great vessels
Time frame: At time of anomaly scan, 18+0 to 22+6 weeks gestation
Frequency of Specific Types of Cardiac Anomalies
Number of each type such as VSD, AVSD, Tetralogy of Fallot, TGA, HLHS among affected fetuses
Time frame: At diagnosis, 18+0 to 22+6 weeks and confirmed by fetal echocardiography
Frequency of NICU Admission
Number of neonates with cardiac anomalies who require NICU admission
Time frame: From birth to discharge, up to 28 days after birth
Frequency of Neonatal Cardiac Surgery
Number of neonates who require cardiac surgery or catheter intervention
Time frame: From birth to 28 days after birth
Frequency of Neonatal Death
Number of neonatal deaths within 28 days among neonates with cardiac anomalies
Time frame: From birth to 28 days after birth
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