Morphological and Physiological Predictors of Fetal Aortic Coarctation

• DOI: 10.1161/circulationaha.108.787598
• Publication Date: 2008-10-14T00:45:24Z
• Authors: Hikoro Matsui; Mats Mellander; Michael Roughton; Hana Jicinska; Helena M. Gardiner
• Keywords: Gestational Age; Sensitivity and Specificity; Aortic Coarctation; Ultrasonography, Prenatal; 03 medical and health sciences; 0302 clinical medicine; Echocardiography; Predictive Value of Tests; Pregnancy; Coronary Circulation; Humans; Female; False Negative Reactions; Retrospective Studies

Background— Prenatal diagnosis of aortic coarctation suffers from high false-negative rates at screening and poor specificity. Methods Results— This retrospective study tested the applicability published arch ductal Z scores (measured just before descending aorta in 3-vessel tracheal view) their ratio on 200 consecutive normal controls a median 22±0 gestational weeks (range, 15±4 to 38±4 weeks). Second, this ability serial distinguish fetuses with within cohort ventricular and/or great arterial disproportion detected or fetal echocardiography. Third, it evaluated diagnostic significance associated cardiac lesions, shelf, isthmal flow disturbance. We studied 44 suspected 24±0 17±3 37±4 Receiver-operating characteristic curves were created. Logistic regression association between z scores, additional diagnoses, coarctation. Good separation was found for cases requiring surgery false-positive cases, receiver-operating showed an excellent area under curve score (0.963) isthmal-to-ductal (0.969). Serial improved >−2 outcomes; those surveillance remained <−2. Minor lesions did not increase specificity coarctation, but disturbance increased odds true versus hypoplasia 16-fold. Conclusions— Isthmal are sensitive indicators measurements abnormal patterns improve may reduce false positives.