Risk of congenital heart disease in first degree relative is

Ans. b (2 to 6%). (Ref. Nelson, Textbook of Paediatrics, 18th/pg. 1878)Congenital heart disease occurs in# 0.5 to 0.8% of live births.# 3 to 4 % of stillboms.# 10 to 25% of abortuses.# 2% of premature infants (except PDA)# 0.8% of normal population.# 2-6% after birth of a child with CHD or if parent affected.# 20-30% when 2 first-degree relatives have congenital heart disease.NOTE: Most congenital defects are well tolerated in the fetus because of the parallel nature of the fetal circulation. Even the most severe cardiac defects (hypoplastic left heart syndrome) can usually be well compensated for by the fetal circulation. It is only after birth when the fetal pathways (ductus arteriosus and foramen ovale) are closed that the full hemodynamic impact of an anatomic abnormality becomes apparent. One notable exception is the case of severe regurgitant lesions, most commonly of the tricuspid valve. In these lesions (Ebstein anomaly), the parallel fetal circulation cannot compensate for the volume load imposed on the right side of the heart. In utero heart failure, often with fetal pleural and pericardial effusions, and generalized ascites (nonimmune hydrops fetalis) may occur.