Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
fetal echocardiography should be part of every prenatal diagnosis for
fetal anomaly. very often simple scan is normal but fetus has severe
cardiac anomalies.
initially, it was recommended that a fetal scan should
include a 4-chamber view of the heart. subsequent studies have shown that
a normal 4-C scan leaves out anomalies of arch and the specificity of 4-C
view was thus low. including rvot and ductal arch and lvot and aortic arch
significantly improves diagnostic returns.
currently, i beleive in uk at
least 90% of pregnant women have at least one fetal scan for the heart
during the pregnancy.
severe heart anomaly could be a reason for MTP.
also delivery of fetuses with severe cardiac anomalies may be better
managed in a center equipped for it.
a particular anomaly, "syndrome" could lead to amniotic or chorionic villi
study for chromosomal anomalies.
finally, in the future, it may be possible to operate fetuses in utero for
instance for aortic valve stenosis which tends to be progressive and end
up with hypoplastic left heart syndrome which may be inoperable post
natal.
intra-uterine balloon angioplasty can also be attempted where feasible.it
is not clear if in this retrospective study, fetal scan included study of
heart.
fetal echocardiography part of prenatal diagnosis
fetal echocardiography should be part of every prenatal diagnosis for
fetal anomaly. very often simple scan is normal but fetus has severe
cardiac anomalies.
initially, it was recommended that a fetal scan should
include a 4-chamber view of the heart. subsequent studies have shown that
a normal 4-C scan leaves out anomalies of arch and the specificity of 4-C
view was thus low. including rvot and ductal arch and lvot and aortic arch
significantly improves diagnostic returns.
currently, i beleive in uk at
least 90% of pregnant women have at least one fetal scan for the heart
during the pregnancy.
severe heart anomaly could be a reason for MTP.
also delivery of fetuses with severe cardiac anomalies may be better
managed in a center equipped for it.
a particular anomaly, "syndrome" could lead to amniotic or chorionic villi
study for chromosomal anomalies.
finally, in the future, it may be possible to operate fetuses in utero for
instance for aortic valve stenosis which tends to be progressive and end
up with hypoplastic left heart syndrome which may be inoperable post
natal.
intra-uterine balloon angioplasty can also be attempted where feasible.it
is not clear if in this retrospective study, fetal scan included study of
heart.
Competing interests:
None declared
Competing interests: No competing interests