الفهرس 
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Abstract
Congenital heart disease, malformation of the heart or great arteries, is the most common form of major birth defect, being six times more common than chromosomal abnormalities and four times more common than neural tube defects. Congenital heart disease accounts for approximately 40% of perinatal deaths due to congenital anomalies, more than 20% of deaths in the first month of life and the majority of deaths from congenital defects in childhood. These defects therefore place a significant economic burden on the NHS and society and the psychological wellbeing of affected families.
Antenatal diagnosis of congenital heart disease allows planning and delivery of timely and appropriate neonatal care. This is increasingly important with accumulating evidence that early diagnosis may have the potential to save babies’ lives. Early knowledge of congenital heart disease also allows further monitoring, testing for known associated non‐cardiac structural and chromosomal anomalies and parental counseling about pregnancy management options including termination.
Various methods of antenatal ultrasound assessment of a baby’s heart are currently available. The ‘four‐chamber view’ is the most basic assessment. This allows a general examination of the main structure of the heart and the atrioventricular junctions. ‘Basic fetal echocardiography’ is a more extensive antenatal ultrasound examination of the heart and its associated structures, through additional assessment of the ventricular outflow tracts. ‘Extended fetal echocardiography’ is also available. During this examination, two‐dimensional scanning of the heart and its associated structures is supplemented by spectral and color‐flow Doppler, and on occasion, M‐mode scanning to assess blood flow within the heart.
Ultrasound has been used as a diagnostic tool to identify congenital heart disease in high risk groups for some years, and has been found to have sensitivities ranging from 60% to 100%. Its routine use in unselected obstetric populations including those at low risk is uncommon and more controversial. Against this background, a systematic review was conducted to determine the accuracy of fetal echocardiography to detect congenital heart disease to inform whether it should be included in a routine 20‐week anomaly scan for an unselected obstetric population including newborn at low risk for developing cardiac defects.
Compared with the assessment of most fetal anatomic structures, the assessment of the fetal heart during routine obstetric screening represents a diagnostic challenge for sonographers and interpreting physicians. This is due to a number of factors: the structural complexity of the heart, the rate at which it moves the position of the fetus relative to the transducer, and variations in assessment protocols used by sonographers and physicians.
Analysis of fetal cardiac function might provide important information on the hemodynamic status and cardiovascular adaptation to different perinatal complications.
An easily measured Inter-Ventricular septum was described in the literature and found to be very effective in evaluation of global systolic and diastolic function of the heart.
The aim of the present study was to assess the role of ultrasound in diagnosis of fetal cardiac anomalies.
This was a cross sectional study that was conducted on 100 pregnant ladies between 18 and 40 weeks gestation dated by LMP referred to fetal echocardiography unit of radiology department of kasr El Ainy from Banha university hospital and other private clinics with suspected cardiac anomalies by routine obstetric ultrasound
The main results of the study revealed that:
There is no significant difference between the studied groups as regard age or gestational age.
By ultrasound percent of Hypertrophic cardiomyopathy was 24%, Isolated ASD 34% and VSD was 26% comparing to 66% Hypertrophic cardiomyopathy, 16% Isolated ASD, 14%VSD and 4%negative with no significant difference between ultrasound and echo in diagnosis of congenital heart.
The incidence of congenital heart defects among study cases represents 8% of the total number of cases.
There were 4 cases of hypertrophic cardiomyopathy one case of VSD and one case of ASD.
Sensitivity of U/S in detection of paediatric hypertrophic cardiomyopathy was 100%, specificity was 97.7%, PPV was 83.3%, NPV was 100% and accuracy was 98%.
Based on our findings, we recommend for further studies on large geographical scale and on larger sample size to emphasize our conclusion.