Our Working Groups play a very important role in the affairs of the Association for European Paediatric Cardiology. It is our hope, therefore, to use our regular Newsletter as a means of providing updates on the activities of these specialised groups. In this first report, we summarise the activities of the Working Group in Fetal Cardiology.

This Working Group has been active since its foundation in 1992. Since then, it has provided regular teaching sessions at our Annual Meetings, either on its own, as occurred during the meeting held in Amsterdam in 2003, or in collaboration with other working groups. Several of our members also organise regular courses, most notably in London and in Austria, that for many years have attracted, and still attract, an international audience. In these meetings, the organisers assemble a multi-disciplinary team of specialists from all over the world, combining expertise in the fields of obstetrics, genetics, paediatric cardiology, and paediatric cardiovascular surgery. Most of the courses also allow “hands-on” training in fetal Doppler-echocardiography. The Austrian week, in Lech, has rightly become recognised as a superbly organised event. It is held in splendid surroundings, combining winter activities with a high standard of basic to advanced training in fetal medicine. More recently, centres in Prague and Poland have also established courses in Fetal Cardiology with international participation.

This year, however, it proved necessary to cancel our winter programme because of the early Easter holidays. To replace this event, the council of the Fetal Working Group organised a Mini-symposium to be held during the annual meeting of the Association in Copenhagen, in May. The symposium was devoted to isolated complete heart block as seen during fetal life. It was chaired by Helena Gardiner and Klaus Schmidt. The first speaker was Gurleen Sharland, who spoke on pathogenesis and risk assessment of anti-Ro-positive pregnant women, and fetal outcome. Sven Erik Sonesson then considered the surveillance of pregnancies at risk for fetal heart block, Edgar Jaeggi discussed the results of transplacental fetal treatment, and Elisabeth Villain concluded the mini-symposium by addressing the topic of postnatal management from birth to adulthood.

A further symposium arranged by the Working Group will be held at the World Congress, in Buenos Aires, in September. This will be chaired by Jose Areias and Jan Marek. James C Huhta has been invited to speak on homocysteine and folic acid in the development and prevention of congenital heart defects, Gerald Tulzer on how to select patients for prenatal intracardiac interventions, and Gurleen Sharland on difficulties and dilemmas in counseling.

Following the business meeting held last year in Munich, three documents previously present have been removed from the web page of the Association. These were the results of the questionnaire on organization of fetal cardiology in Europe, the protocol for fetal supraventricular tachycardia, and the protocol for fetal atrioventricular dissociation. The “Recommendations for the practice of fetal cardiology in Europe”, however, has now been added to the main web page.

The council of the Working Group is now exploring the possibility of designing a unique web page, to be linked directly to the new web page of the Association. Renate Oberhoffer and Kirsten Heiss, from Munich have prepared a proposal, which was presented and discussed at the business meeting in Copenhagen.

During the Annual Meeting held in Munich in 2004, we also discussed and agreed to create a central registry for a few selected fetal diagnoses. Those chosen were supraventricular tachycardia, atrioventricular dissociation, aortic valvar stenosis and atresia, and pulmonary valvar stenosis and atresia. Joanna Dangel and Rodney Franklin are now preparing a modified version of the Polish fetal database so as to collate the data arising from these collaborations. When completed, it will also contain a registry for fetal interventions enrolled on an intention to treat basis.

It is important to be aware, however, that enrolment of cases into the database corresponding to our previously agreed protocol for fetal atrioventricular dissociation proved unsuccessful. To prepare for the prospective collection of the chosen conditions into the new database, therefore, the council agreed first to make a retrospective collection, so as to assess the size of the problem of isolated atrioventricular block, and current practice in its management. To achieve this, an e-mail has been sent to all members of the Fetal Working Group. It contains a simple Excel file that will permit collection of all cases of isolated fetal heart block seen over the past 5 years. Our plan is to finance a young researcher from the Working Group to collect more comprehensive data on each affected case. The council, therefore, would remind all members of the Working Group that they should add their own cases to this registry, and send them to helena.gardiner@imperial.ac.uk

According to the by-laws of our Working Group, the term of Annabelle Azancot as councillor was completed at the annual meeting held in Copenhagen. Any nominations for her replacement, according to the by-laws, had to be supported by at least 5 members from 2 different countries. It is also the case that there should be no more than one representative from the same country on the council. Proposals had to reach mats.mellander@vgregion.se before March 31st. At the time of writing this report, we do not know who was elected as the new councillor, but we are sure that whoever is elected will be warmly welcomed by all the members of the Fetal Working Group.

With regard to upcoming meetings, we have already mentioned that it proved necessary to cancel the meeting scheduled for this year in Lech, Austria. In addition to the symposium due to be held in Buenos Aires, however, the regular meeting “New Horizons in Fetal Cardiology” will be held in London on June 2 and 3. It will be organized by Helena Gardiner and Yen Ho, and all information is available through the link on the web site of the Association, www.aepc.org.

In closing, we would remind you that the current council of our Working Group has Gerald Tulzer, of Linz, Austria, as the President, Mats Mellander, of Göteborg, Sweden, as the secretary, Renate Oberhoffer, of Munich, Germany, as the Treasurer, and Helena Gardiner, of London, United Kingdom, as the sole remaining councillor until we receive the result of the election held in March. All of these members of council are ready and able to answer any queries, or provide more information, about the activities of the Working Group.

Addendum: Vlasta Fesslova, of Milan, Italy was elected new councillor.