Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands

M. E. Baardman; G. J. du Marchie Sarvaas; H. E. K. de Walle; H. Fleurke-Rozema; R. Snijders; T. Ebels; J. E. H. Bergman; C. M. Bilardo; Rudolphus Berger; M. K. Bakker

doi:10.1002/uog.13269

Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands

M. E. Baardman, G. J. du Marchie Sarvaas, H. E. K. de Walle, H. Fleurke-Rozema, R. Snijders, T. Ebels, J. E. H. Bergman, C. M. Bilardo, Rudolphus Berger, M. K. Bakker^*

^*Corresponding author for this work

Cardiovascular Centre (CVC)

Research output: Contribution to journal › Article › Academic › peer-review

18 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate in a population-based cohort the effect of the introduction of the 20-week ultrasound scan in 2007 on the time of diagnosis, pregnancy outcome and total prevalence and liveborn prevalence of cases with selected congenital heart defects (CHDs) in The Netherlands.

METHODS: We included children and fetuses diagnosed with selected severe CHD, born in the 11-year period from 2001 to 2011. Two groups of CHD were defined: those associated with an abnormal four-chamber view at ultrasound (Group 1), and those associated with a normal four-chamber view at ultrasound (Group 2). The time of diagnosis, pregnancy outcome and total liveborn prevalence were compared for both groups over two 5-year periods, before and after the introduction of the 20-week ultrasound scan. Trends in total and liveborn prevalence were examined over 2001 to 2011.

RESULTS: Information was collected on 269 children and fetuses. After the introduction of the 20-week ultrasound scan, the prenatal detection rate of CHDs increased in both groups (Group 1, 34.6% in 2001-2005 vs 84.8% in 2007-2011 (P < 0.001); Group 2, 14.3% in 2001-2005 vs 29.6% in 2007-2011 (P = 0.037)). The rate of termination of pregnancy (TOP) increased significantly only for Group 1 (15.4% vs 51.5% (P < 0.001)). The total prevalence of CHD in Group 1 increased over time from 2.9 per 10 000 births in 2001 to 6.4 per 10 000 births in 2011 (P = 0.016). The liveborn prevalence did not show a trend over time. For Group 2, no trends in total or liveborn prevalence could be detected over time.

CONCLUSIONS: Since the implementation of the routine 20-week ultrasound scan in The Netherlands, prenatal detection rate of selected severe CHDs increased significantly. Improved prenatal detection was accompanied by a more than three-fold increase in TOP, although only in those CHDs with an abnormal four-chamber view at prenatal ultrasound.

Original language	English
Pages (from-to)	58-63
Number of pages	6
Journal	Ultrasound in Obstetrics & Gynecology
Volume	44
Issue number	1
DOIs	https://doi.org/10.1002/uog.13269
Publication status	Published - Jul-2014

Keywords

20-week ultrasound scan
congenital heart anomalies
prenatal screening
PRENATAL-DIAGNOSIS
BIRTH PREVALENCE
MORTALITY
DISEASE
ECHOCARDIOGRAPHY
POPULATION
SMOKING
TRENDS

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Baardman, M. E., Sarvaas, G. J. D. M., de Walle, H. E. K., Fleurke-Rozema, H., Snijders, R., Ebels, T., Bergman, J. E. H., Bilardo, C. M., Berger, R., & Bakker, M. K. (2014). Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands. Ultrasound in Obstetrics & Gynecology, 44(1), 58-63. https://doi.org/10.1002/uog.13269

Baardman, M. E. ; Sarvaas, G. J. du Marchie ; de Walle, H. E. K. ; Fleurke-Rozema, H. ; Snijders, R. ; Ebels, T. ; Bergman, J. E. H. ; Bilardo, C. M. ; Berger, Rudolphus ; Bakker, M. K. / Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands. In: Ultrasound in Obstetrics & Gynecology. 2014 ; Vol. 44, No. 1. pp. 58-63.

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title = "Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands",

abstract = "OBJECTIVES: To evaluate in a population-based cohort the effect of the introduction of the 20-week ultrasound scan in 2007 on the time of diagnosis, pregnancy outcome and total prevalence and liveborn prevalence of cases with selected congenital heart defects (CHDs) in The Netherlands.METHODS: We included children and fetuses diagnosed with selected severe CHD, born in the 11-year period from 2001 to 2011. Two groups of CHD were defined: those associated with an abnormal four-chamber view at ultrasound (Group 1), and those associated with a normal four-chamber view at ultrasound (Group 2). The time of diagnosis, pregnancy outcome and total liveborn prevalence were compared for both groups over two 5-year periods, before and after the introduction of the 20-week ultrasound scan. Trends in total and liveborn prevalence were examined over 2001 to 2011.RESULTS: Information was collected on 269 children and fetuses. After the introduction of the 20-week ultrasound scan, the prenatal detection rate of CHDs increased in both groups (Group 1, 34.6% in 2001-2005 vs 84.8% in 2007-2011 (P < 0.001); Group 2, 14.3% in 2001-2005 vs 29.6% in 2007-2011 (P = 0.037)). The rate of termination of pregnancy (TOP) increased significantly only for Group 1 (15.4% vs 51.5% (P < 0.001)). The total prevalence of CHD in Group 1 increased over time from 2.9 per 10 000 births in 2001 to 6.4 per 10 000 births in 2011 (P = 0.016). The liveborn prevalence did not show a trend over time. For Group 2, no trends in total or liveborn prevalence could be detected over time.CONCLUSIONS: Since the implementation of the routine 20-week ultrasound scan in The Netherlands, prenatal detection rate of selected severe CHDs increased significantly. Improved prenatal detection was accompanied by a more than three-fold increase in TOP, although only in those CHDs with an abnormal four-chamber view at prenatal ultrasound.",

keywords = "20-week ultrasound scan, congenital heart anomalies, prenatal screening, PRENATAL-DIAGNOSIS, BIRTH PREVALENCE, MORTALITY, DISEASE, ECHOCARDIOGRAPHY, POPULATION, SMOKING, TRENDS",

author = "Baardman, {M. E.} and Sarvaas, {G. J. du Marchie} and {de Walle}, {H. E. K.} and H. Fleurke-Rozema and R. Snijders and T. Ebels and Bergman, {J. E. H.} and Bilardo, {C. M.} and Rudolphus Berger and Bakker, {M. K.}",

note = "Copyright {\textcopyright} 2013 ISUOG. Published by John Wiley & Sons Ltd.",

year = "2014",

month = jul,

doi = "10.1002/uog.13269",

language = "English",

volume = "44",

pages = "58--63",

journal = "Ultrasound in Obstetrics & Gynecology",

issn = "0960-7692",

publisher = "Wiley",

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Baardman, ME, Sarvaas, GJDM, de Walle, HEK, Fleurke-Rozema, H, Snijders, R, Ebels, T , Bergman, JEH , Bilardo, CM , Berger, R & Bakker, MK 2014, 'Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands', Ultrasound in Obstetrics & Gynecology, vol. 44, no. 1, pp. 58-63. https://doi.org/10.1002/uog.13269

Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands. / Baardman, M. E.; Sarvaas, G. J. du Marchie; de Walle, H. E. K.; Fleurke-Rozema, H.; Snijders, R.; Ebels, T.; Bergman, J. E. H.; Bilardo, C. M.; Berger, Rudolphus ; Bakker, M. K.

In: Ultrasound in Obstetrics & Gynecology, Vol. 44, No. 1, 07.2014, p. 58-63.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Impact of introduction of 20-week ultrasound scan on prevalence and fetal and neonatal outcomes in cases of selected severe congenital heart defects in The Netherlands

AU - Baardman, M. E.

AU - Sarvaas, G. J. du Marchie

AU - de Walle, H. E. K.

AU - Fleurke-Rozema, H.

AU - Snijders, R.

AU - Ebels, T.

AU - Bergman, J. E. H.

AU - Bilardo, C. M.

AU - Berger, Rudolphus

AU - Bakker, M. K.

PY - 2014/7

Y1 - 2014/7

N2 - OBJECTIVES: To evaluate in a population-based cohort the effect of the introduction of the 20-week ultrasound scan in 2007 on the time of diagnosis, pregnancy outcome and total prevalence and liveborn prevalence of cases with selected congenital heart defects (CHDs) in The Netherlands.METHODS: We included children and fetuses diagnosed with selected severe CHD, born in the 11-year period from 2001 to 2011. Two groups of CHD were defined: those associated with an abnormal four-chamber view at ultrasound (Group 1), and those associated with a normal four-chamber view at ultrasound (Group 2). The time of diagnosis, pregnancy outcome and total liveborn prevalence were compared for both groups over two 5-year periods, before and after the introduction of the 20-week ultrasound scan. Trends in total and liveborn prevalence were examined over 2001 to 2011.RESULTS: Information was collected on 269 children and fetuses. After the introduction of the 20-week ultrasound scan, the prenatal detection rate of CHDs increased in both groups (Group 1, 34.6% in 2001-2005 vs 84.8% in 2007-2011 (P < 0.001); Group 2, 14.3% in 2001-2005 vs 29.6% in 2007-2011 (P = 0.037)). The rate of termination of pregnancy (TOP) increased significantly only for Group 1 (15.4% vs 51.5% (P < 0.001)). The total prevalence of CHD in Group 1 increased over time from 2.9 per 10 000 births in 2001 to 6.4 per 10 000 births in 2011 (P = 0.016). The liveborn prevalence did not show a trend over time. For Group 2, no trends in total or liveborn prevalence could be detected over time.CONCLUSIONS: Since the implementation of the routine 20-week ultrasound scan in The Netherlands, prenatal detection rate of selected severe CHDs increased significantly. Improved prenatal detection was accompanied by a more than three-fold increase in TOP, although only in those CHDs with an abnormal four-chamber view at prenatal ultrasound.

AB - OBJECTIVES: To evaluate in a population-based cohort the effect of the introduction of the 20-week ultrasound scan in 2007 on the time of diagnosis, pregnancy outcome and total prevalence and liveborn prevalence of cases with selected congenital heart defects (CHDs) in The Netherlands.METHODS: We included children and fetuses diagnosed with selected severe CHD, born in the 11-year period from 2001 to 2011. Two groups of CHD were defined: those associated with an abnormal four-chamber view at ultrasound (Group 1), and those associated with a normal four-chamber view at ultrasound (Group 2). The time of diagnosis, pregnancy outcome and total liveborn prevalence were compared for both groups over two 5-year periods, before and after the introduction of the 20-week ultrasound scan. Trends in total and liveborn prevalence were examined over 2001 to 2011.RESULTS: Information was collected on 269 children and fetuses. After the introduction of the 20-week ultrasound scan, the prenatal detection rate of CHDs increased in both groups (Group 1, 34.6% in 2001-2005 vs 84.8% in 2007-2011 (P < 0.001); Group 2, 14.3% in 2001-2005 vs 29.6% in 2007-2011 (P = 0.037)). The rate of termination of pregnancy (TOP) increased significantly only for Group 1 (15.4% vs 51.5% (P < 0.001)). The total prevalence of CHD in Group 1 increased over time from 2.9 per 10 000 births in 2001 to 6.4 per 10 000 births in 2011 (P = 0.016). The liveborn prevalence did not show a trend over time. For Group 2, no trends in total or liveborn prevalence could be detected over time.CONCLUSIONS: Since the implementation of the routine 20-week ultrasound scan in The Netherlands, prenatal detection rate of selected severe CHDs increased significantly. Improved prenatal detection was accompanied by a more than three-fold increase in TOP, although only in those CHDs with an abnormal four-chamber view at prenatal ultrasound.

KW - 20-week ultrasound scan

KW - congenital heart anomalies

KW - prenatal screening

KW - PRENATAL-DIAGNOSIS

KW - BIRTH PREVALENCE

KW - MORTALITY

KW - DISEASE

KW - ECHOCARDIOGRAPHY

KW - POPULATION

KW - SMOKING

KW - TRENDS

U2 - 10.1002/uog.13269

DO - 10.1002/uog.13269

M3 - Article

C2 - 24443357

VL - 44

SP - 58

EP - 63

JO - Ultrasound in Obstetrics & Gynecology

JF - Ultrasound in Obstetrics & Gynecology

SN - 0960-7692

IS - 1

ER -