
This study confirms that the sensitivity of early cardiac screening in pregnancy is roughly 50% (53.8% in our low risk group), due to natural history of CHD and, at least in part relates to human error, and technical issues with image quality. The study was also able to categorize factors responsible for false negative diagnoses, recognizing three types: human, technical, acoustic window impairment. The resulting recommendations are: to use always an appropriate ventral access to the fetal thorax; to adapt color/power Doppler settings to the single case; to spend more time on the assessment of the fetal situs; to adopt a lower threshold for referring doubtful cases for early fetal echocardiography in case of maternal obesity and/or twins.
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