Current Status of Fetal Echocardiography Imaging and Fetal Counseling Fellow Training in 29 European Countries

Limited data exist on the implementation of current fetal cardiology training and practice guidelines, how trainees are assessed, and how trained fetal cardiologists maintain their skills among countries affiliated with the Association of European Paediatric and Congenital Cardiology (AEPC). A structured questionnaire was sent to fetal cardiologists or national delegates from 44 centers in 33 European countries. Responses were obtained from 37 centers in 29 European countries with 31 responses from fetal cardiologists. Fetal echocardiography was equally performed in maternal (18) and pediatric (16) hospitals with median 3 (range 0-6) fetal cardiologists per center and > 4 fetal cardiologists in 13 centers. Core and advanced fetal cardiology training was offered in 17 (46%) and 21 (57%) centers. Advanced training was provided in higher volume centers (19/21). Assessment methods included direct trainee observation, case-based discussions, and participation in multidisciplinary team meetings, with mostly verbal feedback provided. Criteria for independent fetal echocardiography and counseling were based on training duration (range 2-24 months), number of assessments (range 100-1500), and number of counseling abnormal cases (range 40-200) performed under expert supervision, as well as on expert evaluations of trainees based on direct observation and fetal cardiac diagnostic accuracy. Formal certification in fetal cardiology was reported in three centers. Research activity among trained experts was reported among 25 (68%) respondents overall with 19 respondents involved with collaborative research. Trainee research was encouraged but not mandatory in clinical training. Maintenance of expert skills included sufficient clinical activity volume, teaching, and different forms of national and international networking. Fetal cardiology service quality assessments included missed cases discussion in 20 (54%) centers. There is substantial variation in advanced fetal cardiology training practice in Europe suggesting a need for further clarification of training criteria and structure. Trainee assessment is mainly verbal and based on direct observation. There seems to be a need to strengthen the fetal cardiology module in core pediatric cardiology training and to improve quality assessment of the clinical service provided.

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Publication Details

Journal
Pediatric Cardiology
Published
2025-09-01
DOI
https://doi.org/10.1007/s00246-025-04006-0
Citations
1
Primary Topic
Congenital Heart Disease Studies
Type
article
Field-Weighted Citation Impact
1.35

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article

Current Status of Fetal Echocardiography Imaging and Fetal Counseling Fellow Training in 29 European Countries

Ingūna Lubaua, Simone Goa Diab, Taisto Sarkola, Ulrike Herberg et al.
1 citations
Pediatric Cardiology
Congenital Heart Disease Studies
1.35
article

Current Status of Fetal Echocardiography Imaging and Fetal Counseling Fellow Training in 29 European Countries

Ingūna Lubaua, Simone Goa Diab, Taisto Sarkola, Ulrike Herberg, Joana Miranda, Anna N. Seale, Sophie Duignan, J Steinhard, Skaistė Sendžikaitė, Misha Bhat, Gerald Tulzer, Maria C. Escobar‐Diaz, Vojislav Parezanović, Peter Olejník, Roland Weber, Agnieszka Grzyb, Aphrodite Tzifa, Ellen Vanhie, Andreas Tulzer, Maria Kavga, Colin Joseph McMahon, Viktor Tomek, Zornitsa Vassileva, Charlotte Kruse, Eva-Liina Süüden, Katya De Groote, Jarosław Meyer-Szary, Giulia Tuo, Gylfi Óskarsson, Ioana Dumitrascu‐Biris, Colin J. McMahon, Senka Mesihović Dinarević, Damien Bonnet, Antonis Jossif, Anikó Ladányi, A Turi, Sally-Ann B. Clur, Lila Seidl-Mlczoch
article en
1 citations

Abstract

Limited data exist on the implementation of current fetal cardiology training and practice guidelines, how trainees are assessed, and how trained fetal cardiologists maintain their skills among countries affiliated with the Association of European Paediatric and Congenital Cardiology (AEPC). A structured questionnaire was sent to fetal cardiologists or national delegates from 44 centers in 33 European countries. Responses were obtained from 37 centers in 29 European countries with 31 responses from fetal cardiologists. Fetal echocardiography was equally performed in maternal (18) and pediatric (16) hospitals with median 3 (range 0-6) fetal cardiologists per center and > 4 fetal cardiologists in 13 centers. Core and advanced fetal cardiology training was offered in 17 (46%) and 21 (57%) centers. Advanced training was provided in higher volume centers (19/21). Assessment methods included direct trainee observation, case-based discussions, and participation in multidisciplinary team meetings, with mostly verbal feedback provided. Criteria for independent fetal echocardiography and counseling were based on training duration (range 2-24 months), number of assessments (range 100-1500), and number of counseling abnormal cases (range 40-200) performed under expert supervision, as well as on expert evaluations of trainees based on direct observation and fetal cardiac diagnostic accuracy. Formal certification in fetal cardiology was reported in three centers. Research activity among trained experts was reported among 25 (68%) respondents overall with 19 respondents involved with collaborative research. Trainee research was encouraged but not mandatory in clinical training. Maintenance of expert skills included sufficient clinical activity volume, teaching, and different forms of national and international networking. Fetal cardiology service quality assessments included missed cases discussion in 20 (54%) centers. There is substantial variation in advanced fetal cardiology training practice in Europe suggesting a need for further clarification of training criteria and structure. Trainee assessment is mainly verbal and based on direct observation. There seems to be a need to strengthen the fetal cardiology module in core pediatric cardiology training and to improve quality assessment of the clinical service provided.

Pediatric Cardiology
University College Dublin (IE), Johannes Kepler University of Linz (AT), University of Helsinki (FI), Helsinki University Hospital (FI), Ghent University Hospital (BE), Istituto Giannina Gaslini (IT), Children's Health Ireland at Crumlin (IE), Helsinki Children's Hospital (FI), Minerva Foundation (FI), Antwerp University Hospital (BE), Children's Memorial Health Institute (PL), Kepler Universitätsklinikum (AT), Postgraduate School of Molecular Medicine (PL), Birmingham Women’s and Children’s NHS Foundation Trust (GB), University of Birmingham (GB)
Helsingin Yliopisto
Openalex Percentile: Top 16%
Congenital Heart Disease Studies
1.35
DOIOpen Access PDFOpenAlex
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