A simplified screening for congenital heart defects

Author: Dr. Cătălin Gabriel Herghelegiu

PhD Coordinator: Prof. Dr. Suciu Nicolae

Introduction
Congenital heart defects (CHD) are the most common malformations found in fetuses,
reaching an incidence of up to 12 per 1000 live births, with the majority of cases cd coming from
low-risk population.
Material and Method
In the PhD thesis “Utilitatea secțiunilor 4 camere și 3 vase în evaluarea cordului fetal” a
simplified protocol for detecting CHD was developed, using just 2 planes: the 4 chamber view and
the 3 vessel view. The performance of this simplified protocol was compared with that of the
ISUOG protocol, that consists of 4 planes, by interpreting 300 ultrasound scans. The interpretation
using the 2 protocols was made by 5 obstetricians.
Results
Using the simplified protocol, proposed in the PhD thesis, a detection rate of 89% was
obtained, compared to 92% for the ISUOG protocol. The false positive rate for the simplified
protocol was 6% and for the ISUOG protocol was 8%.
Discussions
Although a number of screening protocols exist, with multiple planes that should detect all
pathological cases, the detection rate of CHD in developed countries such as USA and England is
just 50%. A possible explanation for this is that these protocols are too complex to be implemented
by all the personnel performing prenatal screening. Thus a simplified protocol, like the one
proposed, could provide better results.
Conclusions
The good performance in detecting CHD of the simplified protocol is proven by the detection
rate of 89% which is similar to that of the ISUOG protocol that uses 4 planes. The false positive
rate was just 6%, being 25% smaller than that of ISUOG protocol. Thus using a simplified
protocol, we obtain similar results to those obtained using a much more complex protocol that is
inadequate for screening