Fetal cardiac diagnostics in Indonesia: a study of screening and echocardiography.

INTRODUCTION

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 (40-60 %), and fetal echocardiography (FE), the gold standard with over 90 % sensitivity but limited access due to infrastructural and financial challenges.

CONTENT: This review analyzes Indonesia's 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.

SUMMARY: AI has the potential to boost FCS sensitivity by up to 30 %, 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.

OUTLOOK: 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.