HMN 2025: How Advances in ultrasound drive gains in prenatal heart defect detection, but regional gaps remain

A study published in The Annals of Thoracic Surgery suggests that prenatal detection of congenital heart disease (CHD) has improved in recent years, largely due to advances in ultrasound screening practices.

The research highlights that adding specific heart views during pregnancy scans has helped doctors detect more heart defects before birth. However, the study also found that detection rates still vary by region and type of defect, pointing to a need for continued improvements in prenatal care.

Prenatal detection rates of CHD steadily increased from 2006 to 2023, reflecting advances in ultrasound screening. Highlighting the impact of the 2013 guideline updates, prenatal detection rates have increased for lesions not routinely detected on a 4-chamber view but visible on outflow tract views, in comparison to those routinely detected on a 4-chamber view.

“Despite overall progress, detection rates still vary significantly by region and type of defect,” said Dr. Jeffrey Jacobs, lead author and professor of surgery and pediatrics at the University of Florida. “These differences reflect persistent disparities in prenatal CHD diagnosis across the U.S.”

The study analyzed data from the STS Congenital Heart Surgery Database, covering over 100,000 infants who had initial heart surgeries over 17.5 years. Researchers compared prenatal CHD detection rates before and after the 2013 ultrasound guideline update, breaking down findings by year, region, defect type, and imaging method (standard vs. advanced views).

While the study shows progress in prenatal CHD detection, some lesion types remain underdetected, highlighting the need for continued improvements in obstetric screening. Clinicians and health systems can use these findings to refine ultrasound protocols and enhance training, especially for outflow tract views.

Future research should examine how earlier detection affects surgical timing, postnatal outcomes, and long-term health, as well as whether higher detection rates translate into improved results.

“As screening guidelines evolve, equitable access to quality imaging and skilled sonographers will be essential to reducing disparities,” said Dr. Jacobs.

Provided by
The Society of Thoracic Surgeons

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