Identification of fetal cardiac anatomy and hemodynamics: a novel enhanced screening protocol

Zhang, Ying; Cai, Ailong; Ren, Weidong; Guo, Yajun; Zhang, Dongyu; Sun, Wei; Wang, Yu; Wang, Lei; Qin, Yue; Huang, Liping

doi:10.1186/s12884-016-0933-9

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…Therefore, fetal echocardiography guidelines in Japan suggest that another fetal heart screening be performed at approximately 30 GW. A recent paper has revealed that the use of color Doppler may lead to improved detection rates for valvular abnormalities, and color Doppler may therefore be useful in fetal cardiac screening.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of fetal cardiac screening for congenital heart disease using a combination of the four‐chamber view and three‐vessel view during the second trimester scan

Itsukaichi

Serikawa

Yoshihara

et al. 2017

J of Obstet and Gynaecol

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Aim: We aimed to assess the accuracy and effectiveness of fetal cardiac screening for congenital heart disease (CHD) during the second trimester by general obstetricians in a non-selected population. Methods: In this multicenter, prospective cohort study of fetal cardiac screening, four-chamber and threevessel views were recorded by obstetricians at 18-21 gestational weeks (GW). A total of 3005 fetuses that were scheduled for delivery at our institution were included. Results: Thirty-seven newborns were born with CHD (1.2%). On excluding 23 cases of ventricular septal defects, the prenatal detection rate of CHD was 42.8%. Although six cases (75.0%) of severe structural abnormality were diagnosed prenatally, the prenatal detection rate of valvular abnormalities was 0%. Conclusion: One-point ultrasound screening of the fetal heart using a combination of four-chamber and three-vessel views at 18-21 GW by general obstetricians in a non-selected population may be useful for detecting severe structural abnormalities but not valvular abnormalities. However, this limitation may be improved by conducting another fetal cardiac screening at approximately 30 GW along with the routine use of color Doppler.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of fetal cardiac screening for congenital heart disease using a combination of the four‐chamber view and three‐vessel view during the second trimester scan

Itsukaichi

Serikawa

Yoshihara

et al. 2017

J of Obstet and Gynaecol

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“…The addition of a color Doppler evaluation of the fetal heart during routine second-trimester sonography in low-risk patients had been reported to improve the detection rates for valvular abnormalities including PS. 32 33 Our findings can be used to improve prenatal detection of isolated VSD and PS in a low-risk population. In women with low PAPP-A, high AFP, or high inhibin-A, even if major heart abnormalities are not found on detailed sonography in the second trimester, efforts might be continued to find CHDs including isolated VSD or PS using an additional ultrasonogram with or without color Doppler.…”

Section: Discussionmentioning

confidence: 88%

Prenatal Diagnosis of Congenital Heart Diseases and Associations with Serum Biomarkers of Aneuploidy: A Multicenter Prospective Cohort Study

et al. 2022

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Purpose We assessed prenatal detection rates of congenital heart disease (CHD) and associations between maternal serum biomarkers and non-chromosomal CHD in singleton pregnancies. Materials and Methods This study was conducted as a secondary analysis of data obtained during a multicenter prospective cohort study that investigated the cost-effectiveness of prenatal testing for fetal aneuploidy. We analyzed the prenatal detection rate and accuracy for CHD screening via ultrasound during the second trimester, as well as associations between serum biomarkers and CHDs, in singleton newborns without chromosomal abnormalities. Results Among 6715 women, 142 (2.1%) newborns were born with CHDs, of which 67 (1.0%) newborns had major CHDs. The prenatal detection rate for all CHDs and major CHDs were 34.5% and 58.2%, respectively. After excluding isolated ventricular septal defects, the detection rate for critical CHDs was 85.9%. Women with low pregnancy-associated plasma protein A (PAPP-A) (<0.4 multiples of the median, MOM) face increased risks of non-chromosomal CHDs [adjusted odds ratio (aOR) 2.76; 95% confidence interval (CI) 1.36–5.13] and major CHDs (aOR 7.30; 95% CI 3.18–15.59), compared to those without CHDs. A higher inhibin A level (≥2.5 MOM; aOR 4.84; 95% CI 1.42–12.46) was associated with non-chromosomal major CHDs. Conclusion Ultrasonography performed during the second trimester by obstetricians detected over 85% of critical CHDs. Low maternal serum PAPP-A or high inhibin-A was associated with non-chromosomal CHDs. These results may contribute to an improvement in prenatal diagnosis of CHDs.

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“…The Routine Antenatal Diagnostic Imaging with Ultrasound (RADIUS) experiment found that the diagnostic accuracy of anatomical abnormalities in the non teaching environment is lower (9). The demonstration of the left and right ventricular outflow pathways takes more time and demands even greater expertise.…”

Section: Discussionmentioning

confidence: 99%

Establishing Normal Range of Fetal Pulmonary Artery and Fetal Aortic Diameter in 18-26 Weeks of Gestation in Pakistani Population

Nadeem¹,

Malik²,

Niazi³

et al. 2022

PJMHS

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Congenital heart diseases constitute almost 0.8 to 1.2% of newborn illnesses globally however unfortunately 64% of them remained undiagnosed on conventional anamoly scan which uses four chamber view for cardiac evaluation. In developed countries, other than routine anomaly scan, the three vessel view(3VV) has been added to look for any potential outflow tract anomalies which increased the sensitivity of screening CHD however this view is not routinely used in our clinical practice due to lack of expertise and less awareness regarding the importance of this view . We aimed to establish normal reference values of fetal pulmonary and fetal aorta diameter value using 3VV so that its routine use can increase diagnostic accuracy of anamoly scan in our population. Methodology: This is a non probability convenient study investigating healthy pregnant females between 18-26weeks of gestation conducted from 04-02-2022 to 04-08-2022. After formal ethical approval, 56 patients were included in the study. After achieving 3VV,fetal pulmonary artery and fetal aorta diameter were evaluated and mean values were calculated for each gestational week. Results: The mean age of pregnant females included is 27.3 + 4.4 years (range 20 -37 years). The pulmonary artery diameter ranged from 2.3mm at 18 week of gestation to 3.6mm at 26 week of gestation. Fetal PAD is observed to correlate linearly (r=0.887) with gestational age and linear regression equation derived as PAD= (-0.52) +0.15(GA). Mean fetal aortic diameter was calculated ranged from 1.5mm at 18 week of gestation to 1.6mm at 26week of gestation. Fetal aorta diameter correlation with gestational was found to be 0.164 showing weak correlation along with insignificant regression analysis hence the regression equation cannot be formulated for fetal aorta. Conclusion: Normal mean values of fetal pulmonary artery and fetal aorta from 18-26weeks of gestation were calculated. Linear relationship was found between pulmonary artery diameter and gestational age. However weak correlation noted between fetal aorta diameter and gestational age was noted. Keywords: Fetal pulmonary artery; fetal aorta; anamoly scan; three vessel view(3VV); normal range.

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Identification of fetal cardiac anatomy and hemodynamics: a novel enhanced screening protocol

Cited by 8 publications

References 31 publications

Effectiveness of fetal cardiac screening for congenital heart disease using a combination of the four‐chamber view and three‐vessel view during the second trimester scan

Effectiveness of fetal cardiac screening for congenital heart disease using a combination of the four‐chamber view and three‐vessel view during the second trimester scan

Prenatal Diagnosis of Congenital Heart Diseases and Associations with Serum Biomarkers of Aneuploidy: A Multicenter Prospective Cohort Study

Establishing Normal Range of Fetal Pulmonary Artery and Fetal Aortic Diameter in 18-26 Weeks of Gestation in Pakistani Population

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