Document Detail


Sonographic markers of hemoglobin Bart disease at midpregnancy.
MedLine Citation:
PMID:  14756353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the efficacy of various sonographic markers at midpregnancy in predicting fetal hemoglobin Bart disease. METHODS: Four hundred eighty-eight pregnancies at risk of having fetuses with hemoglobin Bart disease were recruited for prenatal diagnosis with cordocentesis at 18 to 21 gestational weeks. Before cordocentesis, the sonographic markers, including cardiothoracic ratio, placental thickness, pericardial effusion, pleural effusion, ascites, subcutaneous edema, cord edema, dilated umbilical vein, and amniotic fluid index, were assessed and recorded. The definite fetal diagnosis was based on blood analysis. The efficacy of each sonographic marker in predicting hemoglobin Bart disease was evaluated by sensitivity and specificity. RESULTS: Among 488 pregnancies undergoing prenatal diagnosis, 100 fetuses were proved to be affected by hemoglobin Bart disease. The cardiothoracic ratio gave the highest sensitivity, 95.0%, with specificity of 96.1%, followed by placental thickness. Signs of hydrops fetalis were observed in 33.0% of cases; they did not increase the sensitivity of the cardiothoracic ratio but strongly reinforced the diagnosis when they appeared. CONCLUSIONS: At midpregnancy, sonographic markers can effectively differentiate normal pregnancies from those with fetal hemoglobin Bart disease. Among couples at risk with no sonographic markers, the risk of having an affected child is nearly eliminated. The most sensitive marker was the cardiothoracic ratio, followed by placental thickness.
Authors:
Theera Tongsong; Chanane Wanapirak; Supatra Sirichotiyakul; Pharuhas 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:  23     ISSN:  0278-4297     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-03     Completed Date:  2004-05-17     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:  49-55     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. ttongson@mail.med.cmu.ac.th
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Diseases / ultrasonography*
Fetal Heart / ultrasonography
Humans
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, Second
Pregnancy, High-Risk
Sensitivity and Specificity
Thorax / embryology*,  ultrasonography*
Ultrasonography, Prenatal*
alpha-Thalassemia / ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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