Six years’ Experience of Fetal Echocardiography in Mothers with Gestational Diabetes Mellitus at Army Cardiac Center Lahore

Le résumé fourni par la source

Objective: To evaluate the diagnostic performance of fetal echocardiography for the prenatal detection of congenital heart disease (CHD) in pregnancies complicated by gestational diabetes mellitus (GDM). Study Design: Cross sectional study. Place and Duration of Study: Army Cardiac Center Lahore, Pakistan from July 2019 to July 2025. Methodology: Out of total 2045, thirteen hundred and thirteen pregnant women diagnosed with GDM who underwent fetal echocardiography and had available postnatal echocardiographic confirmation were included. Pre-gestational diabetes, inadequate imaging, absence of postnatal echocardiography, major extracardiac anomalies, chromosomal abnormalities, and incomplete data were excluded. Fetal echocardiography was performed by pediatric cardiologists using standardized protocols. Postnatal echocardiography served as the gold standard. Diagnostic performance parameters; sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Results: A total of 1,313 pregnancies were analysed. Postnatal confirmed CHD was present in 58 cases (4.4%). Fetal echocardiography correctly identified 52 cases (true positives) and missed 6 cases (false negatives), with no false positives. Sensitivity was 89.7%, specificity 100%, Positive predictive value 100%, Negative predictive value 99.5%, and overall diagnostic accuracy 99.5%. Conclusion: Fetal echocardiography demonstrates high diagnostic accuracy for congenital heart disease screening in pregnancies complicated by gestational diabetes mellitus, when validated against postnatal echocardiography, and provides contemporary region-specific evidence from a resource-limited setting.

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