Abstract
The issue of prenatal diagnosis of congenital heart defects (VSV) is closely connected with the development of ultrasound methods. A historical milestone is the beginning of the 1980s, when a two-dimensional image with high resolution was developed.
From the Doppler techniques, enabling the functional evaluation of the fetal heart and fetoplacental circulation, the conventional Doppler method is being developed in the same period, and color Doppler mapping appears at the end of the same decade. In addition to London (L.
Allan) and Paris (L. Fermont), the first workplaces for prenatal diagnosis of congenital heart defects include the Department of Pediatric Cardiology in New Haven, where Joshua Copel and Charles Kleinman published the first works on the fetal heart.
In this context, it is my great pleasure to state that the clinic of the Children's Cardiac Center of the Motol Hospital also belongs among the mentioned workplaces. Thanks to the enormous efforts of M. Šamánek and J. Škovránek, we managed to use the first experience with prenatal heart examination (in 1983) to implement the then generous project.
Thanks to the unified concept of nationwide ultrasound screening for congenital heart defects, introduced in 1986, prenatal ultrasound diagnosis of VSV in the Czech Republic is at a very high level. The results of the program are highly valued in the world and the concept model created in our country is often applied in other European countries as well.
Today, the Czech Republic belongs - in addition to England, France, Finland, Germany and Italy - among the countries in which the screening program is implemented. To ensure effective screening for congenital heart defects, it is necessary to train gynecologists, who form the basic pillar of the entire system.
The examination scheme of the fetal cardiovascular system intended for gynecologists is similar in all countries. It consists in evaluating the four-cavity image and the distance of the two large arteries from the ventricles.
This test can prove practically all serious congenital heart defects. In the Czech Republic, thanks to a sophisticated educational program and especially due to the great interest of gynecologists and obstetricians, about one quarter of all and especially up to three quarters of serious, life-threatening heart defects are diagnosed prenatally.
The trend in capture continues to rise.