**2. Fetal echocardiography, impact on the prognosis**

Fetal echocardiography is born in the late 80s, when the improvement of ultrasound technology has made possible to focus attention on the characteristics of the fetal heart. Huhta JC, one of the pioneers of this method, raised the question if, without the possibility of treating in utero CHD, is it useful or advisable to make the diagnosis in advance, before birth [5]. It is clearly demonstrated that a team consisting of an expert gynecologist and a pediatric cardiologist can make diagnosis of a number of congenital heart defects in the fetal stage with very high degree of accuracy [6]. The prenatal diagnosis of CHD in the last 30 years has reached a high degree of diagnostic accuracy allowing to identify of almost all forms of CHD during fetal life; this is true in most expert centers since the interpretation of fetal echocardiography requires advanced skills. Accordingly, a suspected cardiac abnormality should then always be referred to a fetal cardiology specialist in a tertiary level center for further evaluation. Prenatal diagnosis rates for CHD increased from 23.0% in 1983–1988 to 47.3% in 1995–2000 [6]. Similarly, termination rates increased from 9.9% (between 1983 and 1989) to 14.7% (between 1989 and 2000) [6]. The spectrum of CHD observed before birth appears similar to the spectrum of CHD postnatally detected [6]. Early diagnosis of CHD during fetal echocardiography can influence the prognosis because it can permit the parents and clinicians to treat the defect. In this chapter, we will address pregnancy and delivery management, issues related to voluntary interruption of pregnancy, and fetal interventions.

*The Impact of Fetal Echocardiography on the Prognosis of Congenital Heart Disease DOI: http://dx.doi.org/10.5772/intechopen.104828*
