OP04.04: Efficacy evaluation of graded ultrasound screening for severe congenital heart disease in early pregnancy

Diagnosis of severe congenital heart disease (CHD) in first trimester of pregnancy is critical for earlier clinical intervention and management. We proposed a graded ultrasound screening protocol and assessed its effectiveness in the diagnosis of severe CHD in early gestational period. A total of 17,261 pregnant women screened at our centre from January 2022 to January 2024 were included. Three indicators including nuchal translucency, cardiac four-chamber view, and ductus venosus (DV) flow spectrum via transabdominal (TA) ultrasound conducted at 11-13+6 gestation weeks were considered as initial screening. Any fetus with abnormal indicators were proceeded to undergo secondary TA and transvaginal screening at 13-14+6 gestation weeks, including 6 indicators: cardiac axis and position, DV, inferior vena cava, four-chamber view, outflow tracts, and three-vessel trachea view of fetal heart. Severe CDH, such as atrioventricular septal defect, transposition of the great arteries, asplenia syndrome, were diagnosed (see figure 1). Among the 17,261 individuals, 105 detected with abnormal initial indicators were received second screening. 46 individuals were then diagnosed as severe CDH in the second screening. 79 individuals were finally confirmed with severe CDH, with sensitivity and specificity of 65.82% and 99.97% respectively. Graded ultrasound examination protocol, using 6 ultrasound indicators at 13-14+6 weeks of gestation during second screening, might enhance the diagnostic efficiency of severe CDH in early gestational period. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.