Document Detail

Pulmonary artery/aorta ratio in simple screening for fetal outflow tract abnormalities during the second trimester.
MedLine Citation:
PMID:  17721863     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Congenital heart disease is associated with high mortality and morbidity rates, being the most life-threatening defect in the first month of postnatal life and accounting for approximately half of all childhood mortality from birth defects. Despite this, the prenatal detection rate for congenital outflow tract anomalies by ultrasound imaging is relatively low. The aim of this study was to establish a nomogram for the pulmonary artery/aorta (PA/AO) ratio measured in the three-vessel view plane. This ratio was investigated as a simple screening tool for congenital cardiac outflow tract abnormalities. METHODS: The study was a prospective evaluation of 966 singleton fetuses at 16-24 weeks of gestation and 46 fetuses with congenital cardiac outflow tract abnormalities. The diameters of the pulmonary artery and aorta were measured in the three-vessel view. The PA/AO ratio was calculated and a nomogram was constructed. The mean and 95% CI for the ratio were defined and the PA/AO ratios of cases with outflow tract abnormalities were plotted against the values for normal fetuses. RESULTS: The gestational age of the normal group ranged from 16 to 24 weeks, with a median of 19 weeks. The pulmonary artery diameter measured between 2.1 and 4.93 mm (mean, 3.3 mm) and the aorta measured between 2.1 and 5.2 mm (mean, 2.93 mm). The mean (SD) PA/AO ratio was 1.16 (0.18) (95% CI, 0.87-1.58; range 0.61-1.86; median, 1.14). For fetuses with outflow tract abnormalities, the median gestation was 19 weeks and 37/43 (86%) had a PA/AO ratio outside the 95% CI. CONCLUSIONS: The PA/AO ratio derived from measurements in the three-vessel view plane can be used as an initial screening tool for outflow tract anomalies and may have a sensitivity of up to 86%, with a 5% false-positive rate.
S F Wong; C Ward; A Lee-Tannock; S Le; F Y Chan
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  30     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-30     Completed Date:  2008-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  275-80     Citation Subset:  IM    
Copyright Information:
Copyright 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Maternal Fetal Medicine, Mater Mothers' Hospital, South Brisbane, QLD, Australia.
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MeSH Terms
Aorta / embryology,  pathology,  ultrasonography*
Fetal Diseases / ultrasonography*
Fetal Heart / ultrasonography
Gestational Age
Heart Defects, Congenital / pathology,  ultrasonography*
Mass Screening / methods
Observer Variation
Pregnancy Trimester, Second
Prospective Studies
Pulmonary Artery / embryology,  pathology,  ultrasonography*
Ultrasonography, Prenatal / methods

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