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First trimester detection of cardiac defects with the use of ductus venosus blood flow.
MedLine Citation:
PMID:  23152003     Owner:  NLM     Status:  Publisher    
Objective: The aim of this study was to assess the best method of combining the fetal nuchal translucency (NT) and ductus venosus (DV) blood flow in the detection of cardiac defects in chromosomally normal fetuses, during the first trimester scan. Study Design: During an 8-year period NT and the DV blood flow were routinely assessed at 11-14 weeks. Only chromosomally normal singleton pregnancies were included in the study. When a cardiac defect was suspected, or when an increased fetal NT or/and an abnormal DV blood flow were observed, early fetal echocardiogram was offered. Data on routine second and third trimester scans, neonatal follow-up or post-mortem examination were obtained from hospital records. The detection rate and false-positive rate were calculated for all major cardiac defects, considering several screening strategies: NT, Ductus Venosus Pulsatility Index (DVPI), or both above a fixed normal centile; abnormal DV A-wave; risk based on NT and DVPI or A-wave above a fixed normal centile; and combinations of these. Results: The study population included 37 chromosomally normal fetuses with a major cardiac defect and 12,799 unaffected pregnancies. Fetal NT above the 95(th) or the 99(th) centile and abnormal DV flow was observed in 40%, 27%, and 39% of the major cardiac defects, respectively. A 47% detection rate with a 2.7% false positive rate were obtained when an abnormal DV or NT above 99(th) centile were used as the selection criteria. Conclusions: Half of major fetal cardiac defects can be detected in the first trimester if NT and DV are used to select 2.7% of the normal pregnant population for fetal extended echocardiogram. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Antoni Borrell; Maribel Grande; Mar Bennasar; Virginia Borobio; Jose Miguel Jimenez; Iosifina Stergiotou; Howard Cuckle
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
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:  Ultrasound Obstet Gynecol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.
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