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Trends in fetal echocardiography and implications for clinical practice: 1985 to 2003.

Publication ,  Journal Article
Hamar, BD; Dziura, J; Friedman, A; Kleinman, CS; Copel, JA
Published in: J Ultrasound Med
February 2006

OBJECTIVE: The purpose of this study was to determine whether patterns of referral for fetal echocardiography (FE) and the subsequent yield for structural congenital heart disease (CHD) have changed between 1985 and 2003. METHODS: All FE performed between 1985 and 2003 at Yale-New Haven Hospital was reviewed. The primary indication for study and the presence of structural CHD were recorded, and data were analyzed for trends. Linear regression with Pearson coefficient calculation and Mantel-Haenszel chi(2) analysis were performed (P < .05 significant). RESULTS: Between 1985 and 2003, 10,806 patients had FE at Yale-New Haven Hospital, and 774 cases of structural CHD were detected. The annual number of studies and rate of detected structural CHD remained constant through the study period. There was a significant increase in the proportion of studies for diabetes, maternal structural CHD, suspicious 4-chamber heart, and family history of cardiac disease. There was a significant decrease in the proportion of studies for a previous child with structural CHD, cardiac teratogen exposure, other fetal anomalies, aneuploidy, fetal arrhythmia, and nonimmune hydrops. The percentage of structural CHD detected by indication remained constant through the study period. Subgroup analysis of diabetes revealed an increase in class B diabetes, while classes C and D remained stable. CONCLUSIONS: This is one of the largest series of FE and suggests that the pattern of indications has changed since 1985. Specifically, referral for diabetes (mostly class B) has increased without a change in yield of structural CHD by indication for sonography. The changing referral patterns reflect a change in obstetric demographics and has implications for obstetric care.

Duke Scholars

Published In

J Ultrasound Med

DOI

ISSN

0278-4297

Publication Date

February 2006

Volume

25

Issue

2

Start / End Page

197 / 202

Location

England

Related Subject Headings

  • Ultrasonography, Prenatal
  • Referral and Consultation
  • Pregnancy
  • Nuclear Medicine & Medical Imaging
  • Linear Models
  • Humans
  • Heart Defects, Congenital
  • Female
  • Echocardiography
  • Chi-Square Distribution
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hamar, B. D., Dziura, J., Friedman, A., Kleinman, C. S., & Copel, J. A. (2006). Trends in fetal echocardiography and implications for clinical practice: 1985 to 2003. J Ultrasound Med, 25(2), 197–202. https://doi.org/10.7863/jum.2006.25.2.197
Hamar, Benjamin D., James Dziura, Alan Friedman, Charles S. Kleinman, and Joshua A. Copel. “Trends in fetal echocardiography and implications for clinical practice: 1985 to 2003.J Ultrasound Med 25, no. 2 (February 2006): 197–202. https://doi.org/10.7863/jum.2006.25.2.197.
Hamar BD, Dziura J, Friedman A, Kleinman CS, Copel JA. Trends in fetal echocardiography and implications for clinical practice: 1985 to 2003. J Ultrasound Med. 2006 Feb;25(2):197–202.
Hamar, Benjamin D., et al. “Trends in fetal echocardiography and implications for clinical practice: 1985 to 2003.J Ultrasound Med, vol. 25, no. 2, Feb. 2006, pp. 197–202. Pubmed, doi:10.7863/jum.2006.25.2.197.
Hamar BD, Dziura J, Friedman A, Kleinman CS, Copel JA. Trends in fetal echocardiography and implications for clinical practice: 1985 to 2003. J Ultrasound Med. 2006 Feb;25(2):197–202.

Published In

J Ultrasound Med

DOI

ISSN

0278-4297

Publication Date

February 2006

Volume

25

Issue

2

Start / End Page

197 / 202

Location

England

Related Subject Headings

  • Ultrasonography, Prenatal
  • Referral and Consultation
  • Pregnancy
  • Nuclear Medicine & Medical Imaging
  • Linear Models
  • Humans
  • Heart Defects, Congenital
  • Female
  • Echocardiography
  • Chi-Square Distribution