Reducing the cost of detection of congenital heart disease in fetuses of women with pregestational diabetes mellitus

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
L S BernardA D Hull

Abstract

To provide a cost minimization analysis to support a paradigm shift in the use of comprehensive ultrasound and echocardiography in the prenatal diagnosis of congenital heart disease (CHD) in fetuses of women with diabetes mellitus (DM). In this retrospective cohort study, the diabetic clinic service database of the University of California San Diego was searched from January 2001 to June 2004 for pregnant women with Type I or II DM and HbA1c >6.3%. Subjects underwent comprehensive ultrasound examination (with four-chamber views and outflow tracts) and fetal echocardiography according to a standard protocol. Newborns were examined for cardiac defects and underwent postnatal echocardiography as indicated. The cost of screening was evaluated. Of 115 neonates and two terminations of pregnancy there were 20 (17%) cases of CHD. Six of these CHD were major and all six were detected prenatally by both ultrasound and echocardiography. Three additional clinically insignificant cases of CHD were identified by fetal echocardiography. Eleven cases of CHD were identified by postnatal echocardiography only, all of which were clinically insignificant lesions. The prenatal detection rate of major CHD was 100% (6/6) for both ultrasound and echoc...Continue Reading

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Citations

Dec 21, 2013·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·N M PintoK J Smith
Aug 6, 2013·Diabetic Medicine : a Journal of the British Diabetic Association·J J NewhamR Bell
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Sep 22, 2011·Obstetrics and Gynecology·Alexander M FriedmanNadav Schwartz
Apr 29, 2020·Journal of Clinical Ultrasound : JCU·Oluyemi A Aderibigbe, Angela C Ranzini
Dec 8, 2011·Arquivos brasileiros de endocrinologia e metabologia·Letícia Schwerz WeinertAngela Jacob Reichelt

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