Factors causing timely referral for fetal echocardiography in the final diagnosis of congenital heart malformations: A crosssectional study

Background: Congenital heart disease (CHD) is one of the most frequently inherited illnesses associated with adverse outcomes. Objective: This study aimed to determine the referral cause for fetal echocardiography in the final diagnosis of major CHD. Materials and Methods: In this cross-sectional study, the data of 1772 pregnant women, referred to a diagnostic clinic during 2017-2020, were reviewed. Data were collected from participants on maternal age, gestational age, history of previous child’s heart disease, body mass, the order of birth of children (baby birth rank), type of woman’s disease, history of poor midwifery, and nuchal translucency (NT). Results: Of the 1772 pregnant women, only 33 women (1.8%) had a fetus with CHD major. Abnormality in ultrasound (57.6%), history of abortion (36.4%), increased NT and gestational diabetes (18.2%) and gestational diabetes (18.2%) were identified as the most common referral reasons for fetal echocardiography in these women. Other reasons included a previous child with Down syndrome (12.1%), a previous child with heart disease (12.1%), a history of stillbirth (12.1%), hypothyroidism (12.1%), taking medication during the pregnancy period (9.0%), no underlying disease (9.0%), multiple pregnancies (6.0%), diagnosis with high-risk fetal heart disease (3.0%), highrisk combined aneuploidy screening test in the first trimester (3.0%), in vitro fertilization pregnancy (3.0%), and having a child with an intellectual disability (3.0%). Conclusion: According to the results, it can be concluded that ultrasound abnormality, abortion, increased NT and gestational diabetes are the most important factors for referring pregnant women for fetal echocardiography. Key words: Echocardiography, Fertilization, Heart diseases, Pregnant women

Sonography in Comparison to Urinary Kit in Intra-Uterine Insemination Timing

Background: Despite all attempts to increase pregnancy rates, overall success rate of Intrauterine Insemination (IUI) is still not acceptable. Proof of ovulation is an important indicator to determine the time of IUI, but to date there is no test proving that the ovulation has definitely occurred. Objective: This study was aimed to compare the efficiency of ultrasound in measuring the size of follicles and urinary Luteinizing Hormone (uLH) kit in determining LH surge for IUI timing. Method: In this comparative, nonrandomized, not blinded clinical trial, 311 IUI cycles in 262 infertile couples who were candidate of IUI were assigned into two groups of ultrasound (n=100 cycles) and uLH kit (n=211 cycles) for IUI timing. Two weeks after doing the IUI, the ßHCG was checked, and chemical pregnancy was confirmed. Four weeks after positive chemical pregnancy test, the fetal heart activity was confirmed by pelvic ultrasonography to confirm clinical pregnancy. Results: Chemical pregnancy rate was lower in ultrasonography group but not significant in comparison to LH kit (14.3% and 18.4%, respectively (P= 0.11)). Clinical pregnancy rate in the groups of ultrasonography and LH kit was respectively 10.3% and 10.3% which did not differ significantly (P= 0.3). Conclusion: Considering that the use of uLH kit is a simple and low cost way and can be done at home by the patients, so the patients can have an active participation in their treatment process