Document Detail

Fetal tricuspid regurgitation at the 11 + 0 to 13 + 6-week scan: association with chromosomal defects and reproducibility of the method.
MedLine Citation:
PMID:  16526003     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the reproducibility of diagnosing tricuspid regurgitation (TR) at 11 + 0 to 13 + 6 weeks' gestation, to examine further the relationship between TR and the presence of chromosomal defects and to calculate the likelihood ratios for trisomy 21 and trisomy 18 in fetuses with TR. METHODS: Pulsed wave Doppler of flow across the tricuspid valve was carried out by 12 obstetricians, trained in fetal echocardiography, to ascertain the presence or absence of TR in 1557 fetuses at 11 + 0 to 13 + 6 weeks. The assessment was carried out immediately before chorionic villus sampling for fetal karyotyping. In 128 cases, assessment of tricuspid flow was also performed by experienced fetal cardiologists to examine the reproducibility of the method. RESULTS: Tricuspid flow was successfully assessed in 1538 (98.8%) cases and TR was present in 58 (4.4%) of the 1323 chromosomally normal fetuses, 77 (67.5%) of the 114 cases with trisomy 21, and 14 (33.3%) of the 42 cases with trisomy 18. The kappa coefficient of agreement between obstetricians and cardiologists was 0.872 (P < 0.0001). Logistic regression analysis demonstrated that, in chromosomally normal fetuses, significant prediction of the likelihood of TR was provided by delta nuchal translucency (NT). The likelihood ratio for trisomy 21 and trisomy 18 for TR, derived by dividing the likelihood (%) of TR in trisomy 21 by the likelihood (%) in normal fetuses, decreased with delta NT. CONCLUSION: At 11 + 0 to 13 + 6 weeks, TR is a common finding in fetuses with trisomies 21 and 18. Assessment of the tricuspid flow can be performed by sonographers trained in fetal echocardiography.
O Falcon; S Faiola; I Huggon; L Allan; K H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  27     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-25     Completed Date:  2007-02-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  609-12     Citation Subset:  IM    
Copyright Information:
Copyright 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.
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MeSH Terms
Chromosome Aberrations*
Chromosomes, Human, Pair 18 / genetics
Clinical Competence
Down Syndrome / ultrasonography
Echocardiography, Doppler, Pulsed / methods
Fetal Diseases / genetics,  ultrasonography*
Gestational Age
Likelihood Functions
Middle Aged
Observer Variation
Prospective Studies
Tricuspid Valve Insufficiency / genetics,  ultrasonography*
Ultrasonography, Prenatal / methods

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