Document Detail


Aberrant Right Subclavian Artery (ARSA). Incidence and correlation with other markers of Down syndrome in 2(nd) trimester fetuses.
MedLine Citation:
PMID:  21793087     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess the incidence of ARSA and other strong markers of DS and their correlation in a large population of 2(nd) trimester DS fetuses assessed in a tertiary referral center. METHODS: Presence or absence of ARSA and other major ultrasound markers of DS was assessed in a population of 106 2(nd) trimester DS fetuses referred to our unit for expert assessment and termination of pregnancy after karyotyping performed for positive 1(st) or 2(nd) trimester screening, maternal age, maternal decision. All cases in which the diagnosis of DS followed the ultrasound detection of major anomalies or soft markers were excluded from the study, as were all cases with a gestational age less than 14 + 0 weeks. The ARSA was searched for on the three-vessel view using color or power Doppler. All fetuses underwent a thorough anatomic assessment and fetal echocardiography. The other DS markers assessed in the study period were: absent or hypoplastic nasal bone (NB-) defined as length < 5(th) centile, nuchal fold (≥ 5 mm), mild pyelectasis. In addition, the presence of major cardiac and extracardiac defects was recorded. A correlation analysis was then performed in order to ascertain possible associations between markers and/or major anomalies. Post-mortem or postnatal diagnostic confirmations were available in all cases. RESULTS: Mean gestational age at ultrasound assessment was 20.4 weeks (SD: 4.1). The incidence of the various variables in the population of DS fetuses was as follows: ARSA 25 25%; NB- 43%; nuchal fold 16%; pyelectasis 17%; major heart defects 41%; AVSD 25%; extracardiac anomaly 24%. The presence of ARSA did not correlate with any of the other variables. The only positive correlations (p < 0.05) were between NB- and pyelectasis, and cardiac and extra-cardiac defects. CONCLUSION: This represents the larger DS population assessed for ARSA. In this series, its incidence is 25%, which is lower than previously reported in much smaller series. Its presence did not correlate with the concurrent presence of any other marker or major anomalies, including heart defects. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
D Paladini; G Sglavo; G Pastore; A Masucci; Mr D'Armiento; C Nappi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-26
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  132     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Fetal medicine and cardiology unit - Dept.Obstetrics and Gynecology University Federico II of Naples, Italy. paladini@unina.it.
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