Cardiology team

Fetal heart anomaly detection

When Orhan Uzun was appointed consultant paediatric cardiologist at the University Hospital of Wales in 2001, antenatal detection of congenital heart defects was poor. “There was a lot of enthusiasm but no leadership and no equity of access,” he says. “People from different parts of the country were not getting the same quality of service. And I wasn’t happy that some people had to travel for two hours to see me—two hours there, two hours back; it wasn’t fair.”

He set out plans for a nationwide improvement through a network of centres, a team approach, and better training for ultrasonographers. “To be honest, a lot of the sonographers lacked confidence,” says Nerys Thomas, superintendent sonographer at the hospital. “There was a steep learning curve across all the centres in south Wales, with lots of local meetings and collaborative working.”

Uzun visited every centre regularly, sitting behind sonographers as they worked to show them how to manipulate the probe to get the best view of the fetal heart. Regular audits were held to measure progress. “Before 2008, we were losing 10% of the babies born with transposition of the great arteries, which was not acceptable,” he says. “Since 2008 we haven’t lost a single baby.” By 2010 Antenatal Screening Wales was able to …