Fetal Echocardiography: Delivery Planning for the Fetus with CHD

Tiny Hearts is a virtual Cleveland Clinic Children’s lecture series dedicated to the topic of neonatal cardiology. Speakers will discuss multiple disciplines and cover topics like pulmonary hypertension, non-invasive monitoring, fetal and neonatal cardiac physiology, interventions for congenital heart disease, neurodevelopmental considerations, electrophysiology and more.

Mary Donofrio, MD, Medical Director of the Prenatal Cardiology Program at Children’s National Hospital Tiny Hearts to discuss fetal echocardiography planning for fetuses with congenital heart disease.

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0:00 Fetal Echocardiography: Delivery Planning for the Fetus with CHD
0:08 Objectives Highlight the importance of perinatal and delivery room planning on outcome in newborns diagnosed
0:40 Fetal Care in the Modern Era Diagnostic precision
1:34 Fetal Diagnosis of CHD: Does it Improve Outcome?
5:15 Fetal Diagnosis: Improved Outcomes Meta-analysis 1373 patients; 22% prenatal diagnosis • Mortality higher in prenatally diagnosed (10% vs 5-6%) • Fetal patient data included higher risk diagnoses and terminations - Fetal diagnosis did not assure optimal postnatal care
6:19 Fetal Circulation
6:42 Postnatal Circulation
7:35 Delivery Room and Transitional Care Management Protocols
9:23 High Risk Diagnoses
9:46 Atrioventricular Canal Defect
10:27 Truncus Arteriosus
11:09 Tetralogy of Fallot
12:41 Tricuspid Atresia
13:13 Hypoplastic Left Heart Syndrome
14:52 HLHS with Restrictive Foramen Ovale: Postnatal Intervention
15:37 TAPVR Four subtypes - Supracardiac
18:02 Ebstein's Anomaly: Management Specialized strategies for ventilation
19:10 Tetralogy with Absent Pulmonary Valve
22:16 Tetralogy with Absent Valve: Utility of MRI
23:03 Tetralogy with Absent Valve: Management
23:35 D-Transposition of the Great Arteries
24:03 D-TGA: Foramen Ovale and Ductus Arteriosus
26:15 D-TGA: In Utero Progression 22 weeks
27:56 D-TGA: Postnatal Management
28:48 Fetal Arrhythmias/Myocardial Dysfunction
31:41 Fetal Tachy/Brady and Myocardial Dysfunction
32:27 Minimizing Hemodynamic Compromise in CHD: Can We Predict Delivery Room Care?
34:53 Predicting Delivery Room Compromise
36:53 High Risk Patients: Specialty Driven Checklists
37:33 What if we can't be there?
37:56 DR Recommendations for Neonatologists
38:32 DR Checklists for Neonatologists
39:26 Delivery Considerations for Obstetricians Delivery method
40:03 Prenatal Diagnosis: Improved Outcome for High Risk CHD

[bubblegumpop]

What is the probability of missing a CHD diagnosis during fetal heart scans ?? Are there many such cases when CHD are missed by radiologists ? What are the reasons that such cases are very frequently missed in countries like India. Is it because of poor quality residency programs ?