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Screening for heart defects

When does a fetal echocardiography become necessary?

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The Foundation of Stars has the privilege of working with researchers from all fields of expertise. In the coming months, we will share with you research projects on different axes of pediatric research. Thus you will discover a multitude of well-popularized scientific advances.

To celebrate February, which is Heart Month, we’ll be unveiling information on pediatric cardiology research and some of the most promising and exciting projects currently underway.

Cardiac malformations are the malformations most frequently observed at the time of birth. Severe cardiac malformations must be treated immediately, i.e., at the time of birth, and many of the children thus afflicted will need to undergo open heart surgery, sometimes before they are even one week old.

Obtaining a cardiac malformation diagnosis prior to delivery (in the womb) is important, increasing the odds of survival while simultaneously bringing about a drop in medical costs and length of hospitalization. Obstetricians and radiologists perform an ultrasonography during the second trimester; most of the malformations are identified during this test (ultrasonography), but some do remain undetected. There are various strategies for improving the chances of identifying cardiac malformations in tiny fetuses. One of them is recommending that pregnant women undergo a special exam, a fetal echocardiography. However, we have yet to determine whether (and if so, at which point in time) it is truly beneficial. Many questions remain unanswered: To what extent can we diagnose cardiac malformations in the womb? Who should undergo a fetal echocardiography? Are some cardiac malformations more difficult to diagnose than others?

The study is aiming to learn more by working with a large group of women who were pregnant between 2007 and 2015. The goal? To determine who benefited from an appropriate prenatal diagnosis and who did not, who underwent a fetal echocardiography and why, and what the repercussions were on ensuing healthcare costs. The answers to these questions will pave the way for the development and testing of new strategies for detecting cardiac malformations prior to birth, with the goal of rendering yet more accurate diagnoses without a spike in healthcare costs. In addition, given that thousands of Québec women undergo such an exam each year, it could be interesting to avoid it in the case of those who don’t require it; this would essentially mitigate the anxiety of undergoing a second procedure and waiting for the results.

Ultimately, this study will allow for more efficiently utilizing resources to screen for severe malformations in the womb and avoid complications during childbirth.