Aim: To analyze prenatal detection rates of complex CHD after the implementation of an expanded three-tiered screening model at the Skane University Hospitals in Lund and Malmö in 2015. Methods: Retrospective review of pregnancies screened from January 1, 2015 and being born by June 30, 2018. Complex CHD was defined as needing intervention in the first year of life. Results: In 27675 screened pregnancies, 51 out of 65 (78 %) cases of complex CHD were detected prenatally. Exclusion of isolated ventricular septal defects yielded detection rates of 93 %. All patients needing surgery within 30 days, potential univentricular hearts and D-transposition of the great arteries were identified, whilst detection rates for tetralogy of Fallot, atrioventricular septal defect and coarctation were about 90 %.
Conclusion: Our three-tiered model results in high detection rates of complex CHD with optimized resource utilization.