Fetal Echocardiography After a Normal Anatomy Assessment: A Retrospective Cohort of In Vitro Fertilization Pregnancies
Brianna Dickson, Hannah Maher, Savannah Maynard, Rachel Scalf, Madison Sundlof, Katelyn M. Tessier, Daniel Peck, Matthew Ambrose, Cresta W. JonesABSTRACT
Purpose
To investigate the detection rate of congenital heart disease (CHD) on fetal echocardiogram after a normal and complete detailed fetal ultrasound among pregnancies conceived by in vitro fertilization (IVF).
Methods
This retrospective cohort study examined singleton IVF pregnancies that underwent a detailed fetal anatomic survey without any identified abnormalities, followed by fetal echocardiogram. The primary outcome was the rate of CHD diagnosis after normal and complete anatomic ultrasound. Patients with multifetal gestation, pre‐gestational diabetes, a known family history of CHD, fetal abnormalities on anatomy ultrasound, or patients who had an incomplete initial anatomy ultrasound were excluded. Prenatal CHD was confirmed with neonatal imaging and infants were followed after birth.
Results
300 pregnancies were included, and of these 266 had a normal and complete anatomy ultrasound. 1.5% ( n = 4) of pregnancies had minor CHD identified on fetal echocardiography which was not identified on the anatomy ultrasound. None of the infants required cardiac‐related interventions in the first year of life.
Conclusion
No major CHD was identified at fetal echocardiography after a normal and complete anatomic survey. Our results support the American Institute of Ultrasound in Medicine guidelines that state a dedicated fetal echocardiogram may be considered, but is not recommended, for singleton IVF pregnancies.