The added value of screening fetal echocardiography after normal cardiac views on a detailed ultrasound.
Prenat Diagn
; 39(12): 1148-1154, 2019 11.
Article
en En
| MEDLINE
| ID: mdl-31499581
ABSTRACT
OBJECTIVE:
Evaluate fetal echocardiography's ability to detect critical (lesions requiring immediate neonatal intensive care) congenital heart disease (CHD) after normal anatomic cardiac views on detailed ultrasound.METHODS:
Singletons with both a detailed ultrasound at 18 + 0 to 22 + 6 weeks and echocardiogram performed at least 14 days later and at 20 + 0 to 24 + 6 weeks. Cases with cardiac pathology on detailed ultrasound were excluded. Different combinations of cardiac views were described Basic (four-chamber, outflow tracts), Expanded (plus three-vessel view), and Complete (plus ductal/aortic arches). "Normal" was defined on either 2D gray scale or color Doppler. Primary outcome was rates of critical CHD missed on ultrasound but seen on fetal echocardiogram.RESULTS:
One thousand two hundred twenty-three women had normal Basic cardiac views. One thousand one hundred ninety (97.3%) were confirmed normal on echocardiogram. Twenty-one (1.71%) total CHDs were missed, and three were critical (0.25%; 95% CI, 0.03%-0.53%). Of the 1,223 women, 763 had Complete views. Ten (1.31%) total CHDs were missed and one (0.13%; 95% CI, 0.13%-0.36%) was confirmed critical.CONCLUSION:
Fetal echocardiography can increase CHD detection despite normal cardiac anatomy on detailed ultrasound; however, CHDs missed are rarely critical. Approximately 750 fetal echocardiograms need to be performed to detect one critical CHD with Complete normal cardiac views on detailed ultrasound.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Ecocardiografía
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Tamizaje Masivo
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Ultrasonografía Prenatal
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Corazón Fetal
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Cardiopatías Congénitas
Tipo de estudio:
Diagnostic_studies
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Evaluation_studies
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Prognostic_studies
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Screening_studies
Límite:
Adult
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Female
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Humans
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Male
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Pregnancy
Idioma:
En
Revista:
Prenat Diagn
Año:
2019
Tipo del documento:
Article