Clinical aspects of prenatally detected congenital heart malformations and the yield of chromosomal microarray analysis

Prenat Diagn. 2016 Dec;36(13):1185-1191. doi: 10.1002/pd.4954. Epub 2016 Nov 29.

Abstract

Objective: The yield of chromosomal microarray analysis (CMA) for prenatally detected congenital heart defects (CHD) is 6.6% to 19.2%. We evaluated the yield of CMA in cases of prenatally detected CHD in regard to specific clinical characteristics.

Methods: Data from 192 cases of CHD including type, clinical and familial background, workup performed during the pregnancy, and pregnancy outcomes were collected.

Results: Fetal echocardiography was performed in all cases; 61.4% of CHD were suspected by ultrasound. There was a positive family history (FH) in 15.7%. Abnormal nuchal translucency or umbilical cord anomalies were detected in 1.7% and 5.9%, respectively, and 55.1% were isolated cases. In 11 of 96 cases in which genetic testing was performed, karyotype and CMA were abnormal (11.5%). The detection rate of CMA (performed in 72 cases) was 9.7%. The yield of CMA was similar in simple cases, isolated cases, and cases with a positive FH. CMA was abnormal in 7.3% of ventricular septal defect cases.

Conclusion: Most cases of prenatally detected CHD had no additional extra-cardiac, sonographic findings suggesting increased risk for CHD. The yield of CMA testing was significant in all clinical scenarios including simple heart malformations, isolated cases, and cases with a positive FH. © 2016 John Wiley & Sons, Ltd.

MeSH terms

  • Adult
  • Chromosome Aberrations
  • Female
  • Genetic Testing
  • Gestational Age
  • Heart Defects, Congenital / diagnosis*
  • Heart Defects, Congenital / genetics*
  • Humans
  • Karyotype
  • Microarray Analysis / methods*
  • Nuchal Translucency Measurement
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Diagnosis / methods*
  • Ultrasonography, Prenatal