Document Detail

Fetal sonographic cardiothoracic ratio at midpregnancy as a predictor of Hb Bart disease.
MedLine Citation:
PMID:  10591443     Owner:  NLM     Status:  MEDLINE    
The objective of this study is to evaluate the efficacy of sonographic cardiothoracic ratio at midpregnancy in predicting fetal hemoglobin Bart disease. Among 17,254 pregnant women screened for severe thalassemia between June 1994 and November 1998, 345 pregnant women at risk for having a fetus with hemoglobin Bart disease underwent ultrasonographic examination and cordocentesis at 18 to 21 weeks' gestation. Before cordocentesis, the cardiothoracic ratio was determined and recorded. The definite fetal diagnosis was based on fetal blood analysis with high performance liquid chromatography. Among 345 pregnancies in which sonographic examination and cordocentesis were performed, 70 fetuses were affected by hemoglobin Bart disease. The mean cardiothoracic ratio was significantly higher than that of unaffected fetuses (0.55 versus 0.45, Student's t-test, P<0.001). The sensitivity and specificity of the cardiothoracic ratio in prediction were calculated for various cutoff values. On the basis of the receiver operating characteristic curve, the best cutoff value was 0.50 (greater than 0.50 considered abnormal), giving the sensitivity of 98.6% and a specificity of 98.9%. In conclusion, the cardiothoracic ratio has very high accuracy in predicting hemoglobin Bart disease in pregnancies at risk. This finding suggests that invasive diagnostic method should be reserved for only the fetuses who have a cardiothoracic ratio of 0.5 or more; however, further studies are needed to confirm this observation.
T Tongsong; C Wanapirak; S Sirichotiyakul; W Piyamongkol; P Chanprapaph
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  18     ISSN:  0278-4297     ISO Abbreviation:  J Ultrasound Med     Publication Date:  1999 Dec 
Date Detail:
Created Date:  1999-12-21     Completed Date:  1999-12-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  807-11     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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MeSH Terms
Fetal Diseases / ultrasonography*
Fetal Heart / ultrasonography*
Predictive Value of Tests
Pregnancy Trimester, Second
Pregnancy, High-Risk*
ROC Curve
Thorax / embryology*,  ultrasonography*
Ultrasonography, Prenatal*
alpha-Thalassemia / ultrasonography*

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