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Prenatal diagnosis of congenital heart diseases by fetal echocardiography in second trimester: a Chinese multicenter study

Acta obstetricia et gynecologica Scandinavica, 2017-04, Vol.96 (4), p.454-463 [Peer Reviewed Journal]

2016 Nordic Federation of Societies of Obstetrics and Gynecology ;2016 Nordic Federation of Societies of Obstetrics and Gynecology. ;Copyright © 2017 Acta Obstetricia et Gynecologica Scandinavica ;ISSN: 0001-6349 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.13085 ;PMID: 28029179 ;CODEN: AOGSAE

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  • Title:
    Prenatal diagnosis of congenital heart diseases by fetal echocardiography in second trimester: a Chinese multicenter study
  • Author: Chu, Chen ; Yan, Yingliu ; Ren, Yunyun ; Li, Xiaotian ; Gui, Yonghao
  • Subjects: Adult ; China ; Echocardiography ; Female ; Fetal Heart - abnormalities ; Fetal Heart - diagnostic imaging ; Fetal Heart - pathology ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - diagnostic imaging ; Humans ; Maternal-Child Health Services ; Performance evaluation ; Population ; Predictive Value of Tests ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Prenatal diagnosis ; Prospective Studies ; termination of pregnancy ; training ; ultrasound ; women's health issues in developing countries
  • Is Part Of: Acta obstetricia et gynecologica Scandinavica, 2017-04, Vol.96 (4), p.454-463
  • Description: Introduction The objective of our study was to evaluate the performance of detailed fetal echocardiography by skilled obstetric physician sonologists in the diagnosis of congenital heart disease (CHD) in a Chinese population. Material and methods This investigation included a multicenter prospective cohort of 10 259 pregnant women attending 10 regional tertiary hospitals in China. The inclusion criteria were singleton pregnancy and gestational age from 18 to ≤28 weeks. Women with multiple pregnancies were excluded. A detailed fetal echocardiography was performed by trained physicians with at least 3 years of experience. The primary outcome measures included sensitivity, specificity, and positive and negative likelihood ratios of detailed fetal echocardiography in prenatal detection of CHD. Results The sensitivity and specificity of fetal echocardiography in detecting any CHD were 33.9 and 99.8%, respectively, in the low‐risk population, and 68.8 and 99.4%, respectively, in the high‐risk population. For detecting major CHDs, fetal echocardiography had a high sensitivity and specificity, and satisfactory positive and negative likelihood ratios in both the low‐risk population (88.2, 100%, 6947.7, and 0.118, respectively) and high‐risk population (100, 99.9%, 833.3, and <0.0001, respectively). The sensitivity and likelihood ratios were substantially lower for detecting minor CHDs in both populations. Conclusions Detailed fetal echocardiography performed by skilled physicians had high detection rate for major CHD in both low‐risk and high‐risk populations. However, its value for detecting minor CHD was limited. The incorporation of fetal echocardiography with multiple cardiac views into routine ultrasound screening may improve the detection rate of fetal major CHD and facilitate appropriate parental counseling.
  • Publisher: United States: John Wiley & Sons, Inc
  • Language: English;French;German
  • Identifier: ISSN: 0001-6349
    EISSN: 1600-0412
    DOI: 10.1111/aogs.13085
    PMID: 28029179
    CODEN: AOGSAE
  • Source: Journals@Ovid Open Access Journal Collection Rolling
    MEDLINE
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