{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:59:50Z","timestamp":1791622790797,"version":"4.3.4"},"reference-count":82,"publisher":"Walter de Gruyter GmbH","issue":"5","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0037_abs_001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Congenital heart defects (CHDs) are a leading cause of neonatal morbidity and mortality globally. Accurate prenatal detection is crucial to improving neonatal outcomes. In Indonesia, two primary methods are used: fetal cardiac screening (FCS), which is accessible but limited in sensitivity (40\u201360\u202f%), and fetal echocardiography (FE), the gold standard with over 90\u202f% sensitivity but limited access due to infrastructural and financial challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0037_abs_002\">\n                    <jats:title>Content<\/jats:title>\n                    <jats:p>This review analyzes Indonesia\u2019s diagnostic disparities, highlighting how rural regions rely heavily on FCS, while FE remains restricted to urban centers. Emerging technologies, such as AI-enhanced diagnostics and telemedicine, show promise in bridging gaps by increasing FCS accuracy and extending access to FE through remote consultations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0037_abs_003\">\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>AI has the potential to boost FCS sensitivity by up to 30\u202f%, making it an effective preliminary screening tool, while telemedicine platforms connect rural practitioners to urban specialists. However, barriers like insufficient infrastructure, regulatory issues, and limited training hinder widespread adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0037_abs_004\">\n                    <jats:title>Outlook<\/jats:title>\n                    <jats:p>Addressing these gaps requires standardized national protocols, capacity-building initiatives, and public-private partnerships to finance infrastructure and reduce costs. With technology integration and systemic reforms, Indonesia can achieve equitable CHD diagnostics, improving maternal and neonatal outcomes and aligning with global standards.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0037","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T11:15:16Z","timestamp":1744715716000},"page":"561-575","source":"Crossref","is-referenced-by-count":9,"title":["Fetal cardiac diagnostics in Indonesia: a study of screening and echocardiography"],"prefix":"10.1515","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-3909","authenticated-orcid":false,"given":"Muhammad Adrianes","family":"Bachnas","sequence":"first","affiliation":[{"name":"Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology , Medical Faculty of Sebelas Maret University, Dr. Moewardi Hospital , Solo, Surakarta , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-8501","authenticated-orcid":false,"given":"Wiku","family":"Andonotopo","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Division, Women Health Center, Department of Obstetrics and Gynecology , Ekahospital BSD City , Tangerang , Banten , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adhi","family":"Pribadi","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology , Faculty of Medicine Padjadjaran University, Hasan Sadikin General Hospital , Bandung , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Dewantiningrum","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology , Medical Faculty of Diponegoro University, Dr. Kariadi Hospital , Semarang , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mochammad Besari","family":"Adi Pramono","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology , Medical Faculty of Diponegoro University, Dr. Kariadi Hospital , Semarang , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri","family":"Sulistyowati","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology , Faculty of Medicine Sebelas Maret University, Sebelas Maret University Hospital , Solo , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Stanojevic","sequence":"additional","affiliation":[{"name":"Medical University of Warsaw, Department of Neonatology and Rare Diseases , Warsaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Kurjak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Medical School University of Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"2026052901123140477_j_jpm-2025-0037_ref_001","unstructured":"Centers for Disease Control and Prevention. Data and statistics on congenital heart defects [Internet]; 2023. Available from: https:\/\/www.cdc.gov\/heart-defects\/data\/index.html."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_002","doi-asserted-by":"crossref","unstructured":"Donofrio, MT, Moon-Grady, AJ, Hornberger, LK, Copel, JA, Sklansky, MS, Abuhamad, A, et al.. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014;129:2183\u2013242. https:\/\/doi.org\/10.1161\/01.cir.0000437597.44550.5d.","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_003","unstructured":"American Institute of Ultrasound in Medicine (AIUM). Practice parameters for the performance of fetal echocardiography [Internet]; 2019. Available from: https:\/\/www.aium.org."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_004","unstructured":"American Society of Echocardiography (ASE). Recommendations for fetal echocardiography [Internet]; 2023. Available from: https:\/\/www.asecho.org."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_005","doi-asserted-by":"crossref","unstructured":"K\u00fchle, H, Cho, SKS, Barber, N, Goolaub, DS, Darby, JRT, Morrison, JL, et al.. Advanced imaging of fetal cardiac function. Frontiers in Cardiovascular Medicine 2023;10:1206138. https:\/\/doi.org\/10.3389\/fcvm.2023.1206138..","DOI":"10.3389\/fcvm.2023.1206138"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_006","unstructured":"World Health Organization. Department of Digital Health and Innovation. Ethics and governance of artificial intelligence for health: WHO guidance. Geneva: World Health Organization; 2021. https:\/\/www.who.int\/publications\/i\/item\/9789240029200."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_007","unstructured":"European Union. Harmonized protocols for congenital heart defect detection in prenatal screening [Internet]; 2023. Available from: https:\/\/ec.europa.eu\/health."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_008","unstructured":"Indonesian Congenital Heart Disease (InaCHD). The 5th InaCHD Scientific Meeting Program Book [Internet]. Jakarta: InaCHD; 2024. Available from: https:\/\/fliphtml5.com\/zfhxr\/ykoo\/The_5th_InaCHD_Program_Book."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_009","unstructured":"International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). Practice guidelines for fetal cardiac screening [Internet]; 2023. Available from: https:\/\/www.isuog.org."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_010","unstructured":"NHS Guidelines: National Health Service (NHS). Fetal anomaly screening program [Internet]; 2025. Available from: https:\/\/www.nhs.uk."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_011","doi-asserted-by":"crossref","unstructured":"Carvalho, JS, Axt-Fliedner, R, Chaoui, R, Copel, JA, Cuneo, BF, Goff, D, et al.. ISUOG Practice Guidelines (updated): fetal cardiac screening. Ultrasound Obstet Gynecol 2023;61:788\u2013803. https:\/\/doi.org\/10.1002\/uog.26224.","DOI":"10.1002\/uog.26224"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_012","unstructured":"Ismail, MT, Hidayati, F, Krisdinarti, L, Noormanto, N, Nugroho, S, Wahab, AS. Epidemiological profile of congenital heart disease\u00a0in\u00a0a\u00a0national referral hospital. Acta Cardiol Indones 2015;1:66\u201372. https:\/\/doi.org\/10.22146\/aci.17811."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_013","unstructured":"Globe, J. Indonesia sees 6,000 preventable deaths among newborns every year: minister [Internet]. Jakarta Globe; 2023. Available from: https:\/\/jakartaglobe.id\/news\/indonesia-sees-6000-preventable-deaths-among-newborns-every-year-minister."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_014","unstructured":"Universitas Gadjah Mada. Early detection of congenital heart disease in children effectively reduces heart disease incidence [Internet]. UGM News Release; 2022. Available from: https:\/\/ugm.ac.id\/en\/news\/early-detection-of-congenital-heart-disease-in-children-effectively-reduces-heart-disease-incidence."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_015","doi-asserted-by":"crossref","unstructured":"Pinto, NM, Nelson, R, Puchalski, M, Metz, TD, Smith, KJ. Cost-effectiveness of prenatal screening strategies for congenital heart disease. Ultrasound Obstet Gynecol 2014;44:50\u20137. https:\/\/doi.org\/10.1002\/uog.13287.","DOI":"10.1002\/uog.13287"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_016","doi-asserted-by":"crossref","unstructured":"Willim, HA, Cristianto, Supit, SAI. Critical congenital heart disease in newborn: early detection, diagnosis, and management. Biosci Med 2020;5:107\u201316. https:\/\/doi.org\/10.32539\/bsm.v5i1.180.","DOI":"10.32539\/bsm.v5i1.180"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_017","doi-asserted-by":"crossref","unstructured":"Carvalho, JS, Mavrides, E, Shinebourne, EA, Campbell, S, Thilaganathan, B. Improving the effectiveness of routine prenatal screening for major congenital heart defects. Heart 2002;88:387\u201391. https:\/\/doi.org\/10.1136\/heart.88.4.387.","DOI":"10.1136\/heart.88.4.387"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_018","unstructured":"World Health Organization. Recommendations for CHD screening in resource-limited settings [Internet]; 2025. Available from: https:\/\/www.who.int."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_019","doi-asserted-by":"crossref","unstructured":"World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191\u20134. https:\/\/doi.org\/10.1001\/jama.2013.281053.","DOI":"10.1001\/jama.2013.281053"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_020","unstructured":"Wells, GA, Shea, B, O\u2019Connell, D, Peterson, J, Welch, V, Losos, M, et al.. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses [Internet]. Ottawa: Ottawa Hospital Research Institut 2014. Available from: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_021","doi-asserted-by":"crossref","unstructured":"Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. https:\/\/doi.org\/10.1371\/journal.pmed.1000097.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_022","doi-asserted-by":"crossref","unstructured":"Higgins, JP, Altman, DG, G\u00f8tzsche, PC, J\u00fcni, P, Moher, D, Oxman, AD, et al.. The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928. https:\/\/doi.org\/10.1136\/bmj.d5928.","DOI":"10.1136\/bmj.d5928"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_023","doi-asserted-by":"crossref","unstructured":"Gardiner, HM. Advances in fetal echocardiography. Semin Fetal Neonatal Med 2018;23:112\u20138. https:\/\/doi.org\/10.1016\/j.siny.2017.11.006.","DOI":"10.1016\/j.siny.2017.11.006"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_024","doi-asserted-by":"crossref","unstructured":"Yeo, L, Romero, R. Fetal cardiac screening: implications for prenatal diagnosis and perinatal outcomes. Ultrasound Obstet Gynecol 2017;50:15\u201324. https:\/\/doi.org\/10.1002\/uog.17401.","DOI":"10.1002\/uog.18889"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_025","doi-asserted-by":"crossref","unstructured":"Zhang, J, Xiao, S, Zhu, Y, Zhang, Z, Cao, H, Xie, M, et al.. Advances in the application of artificial intelligence in fetal echocardiography. J\u00a0Am Soc Echocardiogr 2024;37:550\u201361. https:\/\/doi.org\/10.1016\/j.echo.2023.12.013.","DOI":"10.1016\/j.echo.2023.12.013"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_026","doi-asserted-by":"crossref","unstructured":"Zhang, Y, Kim, J, Kumar, S, Lee, S, Chen, F, Wang, H. Artificial intelligence in fetal echocardiography: a systematic review. J\u00a0Clin Ultrasound 2021;49:212\u201323. https:\/\/doi.org\/10.1002\/jcu.22901.","DOI":"10.1002\/jcu.22901"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_027","doi-asserted-by":"crossref","unstructured":"Ma, K, He, Q, Dou, Z, Hou, X, Li, X, Zhao, J, et al.. Current treatment outcomes of congenital heart disease and future perspectives. Lancet Child Adolesc Health 2023;7:490\u2013501. https:\/\/doi.org\/10.1016\/S2352-4642(23)00076-7.","DOI":"10.1016\/S2352-4642(23)00076-7"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_028","doi-asserted-by":"crossref","unstructured":"Li, YF, Zhou, KY, Fang, J, Wang, C, Hua, YM, Mu, DZ. Efficacy of prenatal diagnosis of major congenital heart disease on perinatal management and perioperative mortality: a meta-analysis. World J Pediatr 2016;12:298\u2013307. https:\/\/doi.org\/10.1007\/s12519-016-0016-z.","DOI":"10.1007\/s12519-016-0016-z"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_029","doi-asserted-by":"crossref","unstructured":"Al-Mesned, A, Al Akhfash, A, Sayed, M. Incidence of severe congenital heart disease at the province of Al-Qassim, Saudi Arabia. Congenit Heart Dis 2012;7:277\u201382. https:\/\/doi.org\/10.1111\/j.1747-0803.2011.00614.x.","DOI":"10.1111\/j.1747-0803.2011.00614.x"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_030","doi-asserted-by":"crossref","unstructured":"Azzahra, SR, Utari, A, Soetadji, A. Clinical characteristics of Down syndrome with congenital heart disease. eJ Kedokt Indonesia 2020;8:33\u20138. https:\/\/doi.org\/10.23886\/ejki.10.108.33.","DOI":"10.23886\/ejki.10.108.33-8"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_031","doi-asserted-by":"crossref","unstructured":"Minnella, GP, Crupano, FM, Syngelaki, A, Zidere, V, Akolekar, R, Nicolaides, KH. Diagnosis of major heart defects by routine first-trimester ultrasound examination: association with increased nuchal translucency, tricuspid regurgitation and abnormal flow in ductus venosus. Ultrasound Obstet Gynecol 2020;55:637\u201344. https:\/\/doi.org\/10.1002\/uog.21956.","DOI":"10.1002\/uog.21956"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_032","doi-asserted-by":"crossref","unstructured":"Bachnas, MA, Andonotopo, W, Dewantiningrum, J, Pramono, MBA, Stanojevic, M, Kurjak, A. The utilization of artificial intelligence in enhancing 3D\/4D ultrasound analysis of fetal facial profiles. J\u00a0Perinat Med 2024;52:899\u2013913. https:\/\/doi.org\/10.1515\/jpm-2024-0347.","DOI":"10.1515\/jpm-2024-0347"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_033","doi-asserted-by":"crossref","unstructured":"Ramirez Zegarra, R, Ghi, T. Use of artificial intelligence and deep learning in fetal ultrasound imaging. Ultrasound Obstet Gynecol 2023;62:185\u201394. https:\/\/doi.org\/10.1002\/uog.26130.","DOI":"10.1002\/uog.26130"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_034","doi-asserted-by":"crossref","unstructured":"Sharma, S, Parness, IA, Kamenir, SA, Ko, H, Haddow, S, Steinberg, LG, et al.. Screening fetal echocardiography by telemedicine: efficacy and community acceptance. J\u00a0Am Soc Echocardiogr 2003;16:202\u20138. https:\/\/doi.org\/10.1067\/mje.2003.46.","DOI":"10.1067\/mje.2003.46"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_035","unstructured":"Brown, P, Singh, K, White, J. Advances in CHD imaging techniques. Int J Epidemiol 2023;48:455\u201378."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_036","doi-asserted-by":"crossref","unstructured":"Carter, J, Brown, P, White, J. The role of machine learning in fetal cardiac diagnostics. Int J Cardiovasc Imaging. 2023;39:234\u201348. https:\/\/doi.org\/10.1007\/s10554-022-02566-3.","DOI":"10.1007\/s10554-022-02566-3"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_037","doi-asserted-by":"crossref","unstructured":"Darmawati, D, Siregar, TN, Kamil, H, Tahlil, T. Barriers to health workers in iron deficiency anemia prevention among Indonesian pregnant women. Anemia 2020:1. https:\/\/doi.org\/10.1155\/2020\/8597174.","DOI":"10.1155\/2020\/8597174"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_038","doi-asserted-by":"crossref","unstructured":"Dewi, PDR, Gunawijaya, E, Yantie, NPVK. Early versus late diagnosis of critical congenital heart disease at Sanglah Hospital Denpasar, Bali. GSC Adv Res Rev 2022;11:72\u20136. https:\/\/doi.org\/10.30574\/gscarr.2022.11.3.0159.","DOI":"10.30574\/gscarr.2022.11.3.0159"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_039","doi-asserted-by":"crossref","unstructured":"Dimiati, H, Lubis, S. Conotruncal heart defects. Indones J Cardiol 2016;36:168\u201374. https:\/\/doi.org\/10.30701\/ijc.v36i3.481.","DOI":"10.30701\/ijc.v36i3.481"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_040","unstructured":"Dinarti, LK, Harimurti, GM, Andari, S, Dewi, YLR, Ariani, R, Abdulah, R, et al.. Screening of congenital heart disease by cardiac auscultation and 12-lead electrocardiogram among Indonesian elementary school students. Cardiol Young 2018;28:1327\u201332. https:\/\/doi.org\/10.1017\/S1047951118001457."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_041","doi-asserted-by":"crossref","unstructured":"Ekawati, FM, Muchlis, M, Iturrieta, N, Putri, DAD. Recommendations for improving maternal health services in Indonesian primary care under the COVID-19 pandemic: results of a systematic review and appraisal of international guidelines. Sex Reprod Healthcare 2023;35:100811. https:\/\/doi.org\/10.1016\/j.srhc.2023.100811.","DOI":"10.1016\/j.srhc.2023.100811"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_042","doi-asserted-by":"crossref","unstructured":"Fedora, K, Utamayasa, IKA, Purwaningsih, S. Profile of acyanotic congenital heart defect in children at Dr. Soetomo General Hospital Surabaya. J Ilm Mahasiswa Kedokt Univ Airlangga 2019;10:147\u201353. https:\/\/doi.org\/10.20473\/juxta.V10I22019.79-82.","DOI":"10.20473\/juxta.V10I22019.79-83"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_043","doi-asserted-by":"crossref","unstructured":"Murni, IK, Wibowo, T, Arafuri, N, Oktaria, V, Dinarti, LK, Panditatwa, D, et al.. Feasibility of screening for critical congenital heart disease using pulse oximetry in Indonesia. BMC Pediatr 2022;22:369. https:\/\/doi.org\/10.1186\/s12887-022-03404-0.","DOI":"10.1186\/s12887-022-03404-0"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_044","doi-asserted-by":"crossref","unstructured":"Nurmaini, S, Partan, RU, Bernolian, N, Sapitri, AI, Tutuko, B, Rachmatullah, MN, et al.. Deep learning for improving the effectiveness of routine prenatal screening for major congenital heart diseases. J\u00a0Clin Med 2022;11:6454. https:\/\/doi.org\/10.3390\/jcm11216454.","DOI":"10.3390\/jcm11216454"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_045","doi-asserted-by":"crossref","unstructured":"Nurmaini, S, Rachmatullah, MN, Sapitri, AI, Darmawahyuni, A, Tutuko, B, Firdaus, F, et al.. Deep learning-based computer-aided fetal echocardiography: application to heart standard view segmentation for congenital heart defects detection. Sensors (Basel) 2021;21:8007. https:\/\/doi.org\/10.3390\/s21238007.","DOI":"10.3390\/s21238007"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_046","doi-asserted-by":"crossref","unstructured":"Nurmaini, S, Sapitri, AI, Tutuko, B, Rachmatullah, MN, Rini, DP, Darmawahyuni, A, et al.. Automatic echocardiographic anomalies interpretation using a stacked residual-dense network model. BMC Bioinf 2023;24:365. https:\/\/doi.org\/10.1186\/s12859-023-05493-9.","DOI":"10.1186\/s12859-023-05493-9"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_047","unstructured":"Nuswil, B, Kesty, C, Widodo, BW. Current update\u00a0on congenital heart\u00a0disease screening in pregnancy. Maj Kedokt Sriwijaya 2020;52:65\u201372. https:\/\/doi.org\/10.36706\/MKS.V52I2.11976."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_048","unstructured":"Ontoseno, T. Congenital heart disease: the holistic approach, now and in the future in Indonesia. Folia Med Indones 2009;45:145\u201354."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_049","doi-asserted-by":"crossref","unstructured":"Pribadi, A, Siddiq, A, Nugrahani, AD, Santoso, DPJ. Case report: 5 cases of variant hypoplastic left heart syndrome diagnosed on prenatal fetal ultrasound. Am J Med Case Rep 2023;24:e940871. https:\/\/doi.org\/10.12659\/AJCR.940871.","DOI":"10.12659\/AJCR.940871"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_050","doi-asserted-by":"crossref","unstructured":"Pribadi, A. Neurodevelopment and fetal growth in fetuses with congenital heart disease. Indones J Obstet Gynecol 2023;11:266\u201371. https:\/\/doi.org\/10.32771\/inajog.v11i4.1751.","DOI":"10.32771\/inajog.v11i4.1751"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_051","doi-asserted-by":"crossref","unstructured":"Putra, BE, Prakoso, R. The importance of early detection of congenital heart disease: prenatal and postnatal screening. J\u00a0Indones Med Assoc 2022;72:56\u20138. https:\/\/doi.org\/10.47830\/jinma-vol.72.2-2022-822.","DOI":"10.47830\/jinma-vol.72.2-2022-822"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_052","doi-asserted-by":"crossref","unstructured":"Rahayuningsih, SE, Kuswiyanto, RB, Suryaningrat, FR, Nataprawira, HM, Sukadi, A. Left to right shunt congenital heart disease as a risk factor of recurrent pneumonia in under five-year-old children: a single center experience in Bandung Indonesia. Med Glas (Zenica) 2021;18:33\u20137. https:\/\/doi.org\/10.17392\/1196-21.","DOI":"10.17392\/1196-21"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_053","doi-asserted-by":"crossref","unstructured":"Murni, IK, Wirawan, MT, Patmasari, L, Sativa, ER, Arafuri, N, Nugroho, S, et al.. Delayed diagnosis in children with congenital heart disease: a mixed-method study. BMC Pediatr 2021;21:191. https:\/\/doi.org\/10.1186\/s12887-021-02667-3.","DOI":"10.1186\/s12887-021-02667-3"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_054","doi-asserted-by":"crossref","unstructured":"Marwali, EM, Purnama, Y, Roebiono, PS. Modalities for early detection of congenital heart disease in primary health services. J\u00a0Indones Med Assoc 2021;71:100\u20139. https:\/\/doi.org\/10.47830\/jinma-vol.71.2-2021-241.","DOI":"10.47830\/jinma-vol.71.2-2021-241"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_055","doi-asserted-by":"crossref","unstructured":"Rahmat, B, Wardana, PWA. Development of pediatric cardiac surgery in Indonesia\u2014a thousand islands and a handful of centers. Indian J Thorac Cardiovasc Surg 2024. https:\/\/doi.org\/10.1007\/s12055-024-01793-8.","DOI":"10.1007\/s12055-024-01793-8"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_056","unstructured":"Sulthoni, FR, Setyoningrum, RA, Utamayasa, IKA. Mortality risk factors in pneumonic children with congenital heart disease left to right shunt: a case-control study [Internet]. Universitas Airlangga Repository; 2021. Available from: https:\/\/repository.unair.ac.id\/120300\/1\/Artikel%201.pdf."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_057","doi-asserted-by":"crossref","unstructured":"Rahayuningsih, S. Familial congenital heart disease in Bandung, Indonesia. Paediatr Indones 2013;53:173\u20136. https:\/\/doi.org\/10.14238\/pi53.3.2013.173-6.","DOI":"10.14238\/53.3.2013.09"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_058","doi-asserted-by":"crossref","unstructured":"Sutarno, S, Nurmaini, S, Partan, RU, Sapitri, AI, Tutuko, B, Rachmatullah, MN, et al.. FetalNet: low-light fetal echocardiography enhancement and dense convolutional network classifier for improving heart defect prediction. Inform Med Unlocked 2022;35:101136. https:\/\/doi.org\/10.1016\/j.imu.2022.101136.","DOI":"10.1016\/j.imu.2022.101136"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_059","doi-asserted-by":"crossref","unstructured":"Damayanti, NA, Wulandari, RD, Ridlo, IA. Maternal health care utilization behavior, local wisdom, and associated factors among women in urban and rural areas, Indonesia. Int. J.\u00a0Womens Health 2023;15:665\u201377. https:\/\/doi.org\/10.2147\/IJWH.S379749.","DOI":"10.2147\/IJWH.S379749"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_060","doi-asserted-by":"crossref","unstructured":"Mozumdar, N, Rowland, J, Pan, S, Rajagopal, H, Geiger, MK, Srivastava, S, et al.. Diagnostic accuracy of fetal echocardiography in congenital heart disease. J\u00a0Am Soc Echocardiogr 2020;33:1384\u201390. https:\/\/doi.org\/10.1016\/j.echo.2020.06.017.","DOI":"10.1016\/j.echo.2020.06.017"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_061","doi-asserted-by":"crossref","unstructured":"Herlambang, H, Fitri, AD, Shafira, NNA, Puspasari, A, Tarawifa, S. The role of clinical supervision: teaching basic obstetric ultrasound for undergraduate medical students. Indones Res. J Educ 2020;4:556\u201368. https:\/\/doi.org\/10.22437\/irje.v4i2.12204.","DOI":"10.22437\/irje.v4i2.12204"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_062","doi-asserted-by":"crossref","unstructured":"Sitorus, BA, Aris, P, Pribowo, P, Irawati, AR. Expert system for pregnant mothers\u2019 treatment and early disease detection for infants and toddlers based on Android (Kasih Ibu). J\u00a0Phys: Conf Ser 2019;1338:012052. https:\/\/doi.org\/10.1088\/1742-6596\/1338\/1\/012052.","DOI":"10.1088\/1742-6596\/1338\/1\/012052"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_063","doi-asserted-by":"crossref","unstructured":"Hunter, LE, Simpson, JM. Prenatal screening for structural congenital heart disease. Nat Rev Cardiol 2014;11:323\u201334. https:\/\/doi.org\/10.1038\/nrcardio.2014.34.","DOI":"10.1038\/nrcardio.2014.34"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_064","doi-asserted-by":"crossref","unstructured":"Kurjak, A, Miskovic, B, Andonotopo, W, Stanojevic, M, Azumendi, G, Vrcic, H. How useful is 3D and 4D ultrasound in perinatal medicine? J\u00a0Perinat Med 2007;35:10\u201327. https:\/\/doi.org\/10.1515\/JPM.2007.002.","DOI":"10.1515\/JPM.2007.002"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_065","doi-asserted-by":"crossref","unstructured":"Kurjak, A, Pooh, RK, Merce, LT, Carrera, JM, Salihagic-Kadic, A, Andonotopo, W. Structural and functional early human development assessed by three-dimensional and four-dimensional sonography. Fertil Steril 2005;84:1285\u201399. https:\/\/doi.org\/10.1016\/j.fertnstert.2005.03.084.","DOI":"10.1016\/j.fertnstert.2005.03.084"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_066","doi-asserted-by":"crossref","unstructured":"Behera, SK, Ding, VY, Chung, S, Tacy, TA. Impact of fetal echocardiography comprehensiveness on diagnostic accuracy. J\u00a0Am Soc Echocardiogr 2022;35:752\u201361.e11. https:\/\/doi.org\/10.1016\/j.echo.2022.02.014.","DOI":"10.1016\/j.echo.2022.02.014"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_067","doi-asserted-by":"crossref","unstructured":"Pinto, NM, Keenan, HT, Minich, LL, Puchalski, MD, Heywood, M, Botto, LD. Barriers to prenatal detection of congenital heart disease: a population-based study. Ultrasound Obstet Gynecol 2012;40:418\u201325. https:\/\/doi.org\/10.1002\/uog.10116.","DOI":"10.1002\/uog.10116"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_068","doi-asserted-by":"crossref","unstructured":"Silveira, DTD, Valete, COS, Lucas, E, Herdy, GVH. Fetal echocardiography indications and lack of association between abnormal exams and advanced maternal age: a cross-sectional study - fetal abnormal echocardiography. Rev Bras Ginecol Obstet 2020;42:805\u201310. https:\/\/doi.org\/10.1055\/s-0040-1718445.","DOI":"10.1055\/s-0040-1718445"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_069","doi-asserted-by":"crossref","unstructured":"Meller, C, Grinenco, S, Aiello, H, C\u00f3rdoba, A, S\u00e1enz-Tejeira, M, Marantz, P, et al.. Congenital heart disease, prenatal diagnosis, and management. Arch Argent Pediatr 2020;118:e149\u201356. https:\/\/doi.org\/10.5546\/aap.2020.eng.e149.","DOI":"10.5546\/aap.2020.eng.e149"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_070","doi-asserted-by":"crossref","unstructured":"Barber, N, Freud, L. Advances in fetal cardiac imaging and intervention. CJC Pediatr Congenit Heart Dis 2023;3:33\u201342. https:\/\/doi.org\/10.1016\/j.cjcpc.2023.10.012.","DOI":"10.1016\/j.cjcpc.2023.10.012"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_071","doi-asserted-by":"crossref","unstructured":"Mocumbi, AO, Sliwa, K, Soma-Pillay, P. Medical disease as a cause of maternal mortality: the pre-eminence of cardiovascular pathology. Cardiovasc J Afr 2016;27:84\u20138. https:\/\/doi.org\/10.5830\/CVJA-2016-018.","DOI":"10.5830\/CVJA-2016-018"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_072","doi-asserted-by":"crossref","unstructured":"Zimmerman, M, Sable, C. Congenital heart disease in low-and-middle-income countries: focus on sub-Saharan Africa. Am J Med Genet, Part C 2020;184:36\u201346. https:\/\/doi.org\/10.1002\/ajmg.c.31769.","DOI":"10.1002\/ajmg.c.31769"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_073","doi-asserted-by":"crossref","unstructured":"Giang, HTN, Hai, TT, Nguyen, H, Vuong, TK, Morton, LW, Culbertson, CB. Elevated congenital heart disease birth prevalence rates found in Central Vietnam and dioxin TCDD residuals from the use of 2,4,5-T herbicides (Agent Orange) in the Da Nang region. PLOS Glob Public Health 2022;2:e0001050. https:\/\/doi.org\/10.1371\/journal.pgph.0001050.","DOI":"10.1371\/journal.pgph.0001050"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_074","unstructured":"Hansahiranwadee, W, Bumrungphuet, S. Perinatal and neonatal outcomes of the prenatal diagnosis of congenital heart disease in Ramathibodi Hospital. J\u00a0Med Assoc Thai 2020;103:315\u201321."},{"key":"2026052901123140477_j_jpm-2025-0037_ref_075","doi-asserted-by":"crossref","unstructured":"Saxena, A. Congenital heart disease in India: a status report. Indian Pediatr 2018;55:1075\u201382. https:\/\/doi.org\/10.1007\/s13312-018-1445-7.","DOI":"10.1007\/s13312-018-1445-7"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_076","doi-asserted-by":"crossref","unstructured":"Bonnet, D. Impacts of prenatal diagnosis of congenital heart diseases on outcomes. Transl Pediatr 2021;10:2241\u20139. https:\/\/doi.org\/10.21037\/tp-20-267.","DOI":"10.21037\/tp-20-267"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_077","doi-asserted-by":"crossref","unstructured":"Wong, J, Kohari, K, Bahtiyar, MO, Copel, J. Impact of prenatally diagnosed congenital heart defects on outcomes and management. J\u00a0Clin Ultrasound 2022;50:646\u201354. https:\/\/doi.org\/10.1002\/jcu.23219.","DOI":"10.1002\/jcu.23219"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_078","doi-asserted-by":"crossref","unstructured":"Maher, S, Seed, M. Fetal cardiovascular MR imaging. Magn Reson Imaging Clin North Am 2024;32:479\u201387. https:\/\/doi.org\/10.1016\/j.mric.2024.04.008.","DOI":"10.1016\/j.mric.2024.04.008"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_079","doi-asserted-by":"crossref","unstructured":"Cutshall, A, Gourdine, A, Bender, W, Karuppiah, A. Trends in outcomes of pregnancy in patients with congenital heart disease. Curr Opin Anaesthesiol 2023;36:35\u201341. https:\/\/doi.org\/10.1097\/ACO.0000000000001208.","DOI":"10.1097\/ACO.0000000000001208"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_080","doi-asserted-by":"crossref","unstructured":"Reynolds, TA, Goldshore, MA, Flohr, S, Land, S, Mathew, L, Gebb, JS, et al.. A clinical outcomes data archive for a comprehensive fetal diagnosis and treatment center. Fetal Diagn Ther 2024:1\u20139. https:\/\/doi.org\/10.1159\/000541877.","DOI":"10.1159\/000541877"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_081","doi-asserted-by":"crossref","unstructured":"Pietrolucci, ME, Maqina, P, Mappa, I, Marra, MC, D\u2019 Antonio, F, Rizzo, G. Evaluation of an artificial intelligent algorithm (Heartassist\u2122) to automatically assess the quality of second trimester cardiac views: a prospective study. J\u00a0Perinat Med 2023;51:920\u20134. https:\/\/doi.org\/10.1515\/jpm-2023-0052.","DOI":"10.1515\/jpm-2023-0052"},{"key":"2026052901123140477_j_jpm-2025-0037_ref_082","doi-asserted-by":"crossref","unstructured":"Rizzo, G, Pietrolucci, ME, Capponi, A, Mappa, I. Exploring the role of artificial intelligence in the study of fetal heart. Int J Cardiovasc Imag 2022;38:1017\u20139. https:\/\/doi.org\/10.1007\/s10554-022-02588-x.","DOI":"10.1007\/s10554-022-02588-x"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0037\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0037\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T01:12:52Z","timestamp":1780017172000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2025-0037\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,16]]},"references-count":82,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,4,16]]},"published-print":{"date-parts":[[2025,6,26]]}},"alternative-id":["10.1515\/jpm-2025-0037"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2025-0037","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"value":"0300-5577","type":"print"},{"value":"1619-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,16]]}}}