Ultrasonographic prediction of homozygous α<sup>0</sup>‐thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: alone or in combination?

α‐Thalassemia prevails in Southeast Asia, where α‐thalassemia major is a lethal type. Sonography is a helpful and cost‐effective screening tool for detecting α‐thalassemia major fetuses. The cardiothoracic ratio, placental thickness, and middle cerebral artery peak systolic velocity are most used in clinical practice. These sensitive markers are helpful for evaluation of the hemodynamic status and cardiovascular function of the affected fetuses. They can predict fetal α‐thalassemia major and assess the efficacy of treatment noninvasively; therefore, the medical costs as well as the possibility of fetal loss caused by invasive procedures can be reduced. Other potentially useful sonographic markers need further studies, although previous preliminary research suggests their usefulness. This article will review those sonographic markers.

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“…A cardiothoracic ratio greater than 0.5 before 17 weeks or 0.52 after 18 weeks is considered abnormal (Figure 1). 29 , 30 …”

Section: Sonographic Markers Of Fetal α‐Thalassemia Majormentioning

confidence: 99%

Sonographic Markers of Fetal α‐Thalassemia Major

Zhou

Zhang

et al. 2015

J of Ultrasound Medicine

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“…Although fetal MCA-PSV is considered the best noninvasive marker in Rhesus isoimmunization, there is no enough data demonstrating that MCA-PSV is as effective in predicting alpha-thalassemia major. Leung et al [13] reported that using MCA-PSV as a parameter in prediction of alpha-thalassemia major during GA 16-20 weeks, the diagnosis may be delayed in 25% of affected pregnancies. Furthermore, by the combination of cardiothoracic ratio (CTR) and MCA-PSV, it tended to increase the sensitivity at GA 12-15 weeks (100%) and decreased the false positive rate at GA 16-20 weeks (0%).…”

Section: Ultrasound Featuresmentioning

confidence: 99%

Lessons Learned from Two Missed Prenatal Cases of Hemoglobin BartÃ¢ÂÂs Hydrops Fetalis Until Second Trimester Despite a Nationwide Screening Program

Wu¹,

Gc²,

Pc³

et al. 2015

Hereditary Genetics

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“…Ultrasound screening is an essential part of early prenatal diagnosis for Hb Bart’s disease before development of hydropic changes. Of ultrasound markers, cardiac diameter to thoracic diameter (C/T) ratio is most accurate in predicting the fetal disease [1,2]. In our practice, C/T ratio is the most common sonomarker used for predicting fetal Hb Bart’s disease.…”

Section: Introductionmentioning

confidence: 99%

Screening for hemoglobin Bart’s disease among fetuses at risk at mid-pregnancy using the fetal cardiac diameter to biparietal diameter ratio

Thathan

Traisrisilp

Luewan

et al. 2014

BMC Pregnancy Childbirth

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BackgroundAll sonomarkers used to screen for fetal hemoglobin (Hb) Bart’s disease need high expertise, preventing them from being widely used. Fetal cardiac diameter to biparietal diameter (C/B) ratio is a simple marker which has never been evaluated for its effectiveness. Therefore, we conducted this study to evaluate the effectiveness of C/B ratio in predicting fetal Hb Bart’s disease among fetuses at risk.MethodsFetuses at risk of Hb Bart’s disease scheduled for diagnostic cordocentesis at 18 to 22 weeks of pregnancy were prospectively enrolled. All underwent ultrasound for fetal biometry and cardio-STIC acquisition for subsequent off-line analysis. Cardio-STIC volume datasets (VDS) were analyzed for cardiac diameter measurement and C/B ratio was calculated by the authors who did not know the fetal diagnosis. Final diagnosis of Hb Bart’s disease was based on fetal blood Hb typing.ResultsOf 131 pregnancies enrolled to the study, 11 were excluded because of poor quality VDS. The remaining 120 were available for analysis. C/B ratio was significantly higher in the fetuses with Hb Bart’s disease than that in the unaffected ones (53.16% vs 41.68%, P < 0.001). C/B ratio could detect fetuses with Hb Bart’s disease with sensitivity of 91.5% and specificity of 77.6% (AUC ROC 0.929), using a cut-off point of greater than 45%.ConclusionsAmong fetuses at risk, C/B ratio measurement at mid-pregnancy, using cut-off point of 45%, could effectively differentiate fetuses with Hb Bart’s disease from unaffected fetuses.

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Ultrasonographic prediction of homozygous α⁰‐thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: alone or in combination?

Abstract: Objective

Cited by 51 publications

References 18 publications

Sonographic Markers of Fetal α‐Thalassemia Major

Sonographic Markers of Fetal α‐Thalassemia Major

Lessons Learned from Two Missed Prenatal Cases of Hemoglobin BartÃ¢ÂÂs Hydrops Fetalis Until Second Trimester Despite a Nationwide Screening Program

Screening for hemoglobin Bart’s disease among fetuses at risk at mid-pregnancy using the fetal cardiac diameter to biparietal diameter ratio

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Ultrasonographic prediction of homozygous α0‐thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: alone or in combination?

Abstract: Objective

Cited by 51 publications

References 18 publications

Sonographic Markers of Fetal α‐Thalassemia Major

Sonographic Markers of Fetal α‐Thalassemia Major

Lessons Learned from Two Missed Prenatal Cases of Hemoglobin BartÃ¢ÂÂs Hydrops Fetalis Until Second Trimester Despite a Nationwide Screening Program

Screening for hemoglobin Bart’s disease among fetuses at risk at mid-pregnancy using the fetal cardiac diameter to biparietal diameter ratio

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Resources

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Ultrasonographic prediction of homozygous α⁰‐thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: alone or in combination?

Lessons Learned from Two Missed Prenatal Cases of Hemoglobin BartÃ¢ÂÂs Hydrops Fetalis Until Second Trimester Despite a Nationwide Screening Program