Citation Information :
Ultrasound in the Service of Early Diagnosis and Treatment of Congenital Heart Defects: Bosnian and Herzegovinian Experience. Donald School J Ultrasound Obstet Gynecol 2020; 14 (2):131-135.
Introduction: Congenital heart defects (CHDs) are the most common congenital anomalies in the pediatric population, representing about one-third of all congenital anomalies in infants. Modern pediatric cardiology deals mainly with CHD. Echocardiography is a well-established diagnostic method in fetal and pediatric cardiology. The paper aimed to show the importance of early diagnosis of CHD in Bosnia and Herzegovina by fetal and pediatric echocardiography to foster the treatment if necessary and to present the outcome of children with early prenatal screening and postnatal diagnosis of CHD. Material and methods: In a retrospective study, we investigated all patients with prenatally detected CHDs at the Department of Obstetrics and Gynecology, University Clinical Center Sarajevo, Bosnia and Herzegovina, in the 8 year period (2012–2020). Results: During this 8 year period, out of 2,620 pregnant women in whom fetal echocardiography was performed as a screening, 64 (2.4%) fetuses were suspected for CHD of which the diagnosis was confirmed postnatally. Out of 64 patients with CHDs, hemodynamically significant CHDs were diagnosed in 22 (34.4%), while in 42 (65.6%) CHDs were mild and hemodynamically nonsignificant. In 16 (25.0%) patients, the CHD was associated with other congenital malformations (syndrome, chromosomopathy). In 28 (43.8%), atrial septal defect (ASD) and ventricular septal defect (VSD) were isolated CHDs, while in 14 they were syndromic. Atrioventricular septal defect (AVSD) was isolated in 1, while in 2 patients it was part of trisomy 21. Other extracardiac congenital anomalies were trisomy 21 in 5 infants, as well as Holt Oram syndrome in 1 infant with VSD. A total of 5 (7.8%) out of 64 patients died (one termination of pregnancy after 18 weeks of gestation, four postnatal deaths). Conclusion: The importance of fetal screening and prenatal diagnosis of patients with CHDs, as well as the postnatal confirmation thereof, enables the timely planning of an intervention in accordance with the needs and better communication and better understanding with the parents. This approach is important for healthcare providers as well and could be proposed as the universal approach at the national level in entire Bosnia and Herzegovina.
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