The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease.
IF 3
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
引用次数: 0
Abstract
Introduction: Fetal echocardiograms (F-echo) are recommended in all pregnancies when maternal congenital heart disease (CHD) is present, even if there was a prior level II ultrasound (LII-US) that was normal. The goal of this study was to evaluate if any diagnosis of a critical CHD was missed in a fetus with maternal CHD who had a normal LII-US.
Methods: A retrospective chart review of all F-echoes where the indication was maternal CHD between 1/1/2015 to 12/31/2022 was performed. Fetuses were included if they had a LII-US that was read as normal and had an F-echo. Critical CHD was defined as CHD requiring catheterization or surgical intervention < 1 month of age.
Results: A total of 296 F-echoes on fetuses with maternal CHD were evaluated, of which 175 met inclusion criteria. LII-US was performed at 19.8 ± 2.9 weeks gestational age and F-echo was performed at 24.2 ± 2.8 weeks gestational age. No patient with a normal LII-US had a diagnosis of a critical CHD by F-echo (negative predictive value = 100%). Evaluating those patients that had a negative LII-US, ten patients were diagnosed with non-critical CHD postnatally (negative predictive value = 94.3%). F-echo correctly diagnosed two of the ten missed LII-US CHD.
Conclusions: Critical CHD was not missed with a normal LII-US in this at risk population. F-echo also missed the majority of CHD when a LII-US was read as normal. A cost-benefit analysis of screening F-echo in fetuses with maternal CHD should be conducted if a normal LII-US has been performed.
对母体患有先天性心脏病的胎儿进行正常二级超声检查后进行胎儿超声心动图筛查的实用性。
简介：如果母体患有先天性心脏病（CHD），即使之前的二级超声检查（LII-US）正常，也建议所有孕妇进行胎儿超声心动图检查（F-echo）。本研究的目的是评估母体有先天性心脏病但 LII-US 正常的胎儿是否漏诊了严重的先天性心脏病：方法：对2015年1月1日至2022年12月31日期间所有以母体CHD为指征的F-回波进行回顾性病历审查。如果胎儿的 LII-US 被判读为正常且有 F 回波，则将其包括在内。重症 CHD 被定义为需要进行导管检查或手术干预的 CHD：共评估了 296 例母体患有先天性心脏病的胎儿的 F 回波，其中 175 例符合纳入标准。LII-US 在胎龄（19.8 ± 2.9）周时进行，F-回波在胎龄（24.2 ± 2.8）周时进行。没有一名 LII-US 正常的患者被 F-echo 诊断为危重先天性心脏病（阴性预测值 = 100%）。在对 LII-US 阴性的患者进行评估后，有 10 名患者在产后被诊断为非危重先天性心脏病（阴性预测值 = 94.3%）。F-回波正确诊断了10例LII-US漏诊的心脏病中的2例：结论：在这一高危人群中，正常的 LII-US 不会漏诊重症心脏病。当 LII-US 被判读为正常时，F-回波也会漏诊大部分冠心病。如果 LII-US 正常，则应对母体有先天性心脏病的胎儿进行 F-回波筛查的成本效益分析。
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来源期刊
Cardiology and Therapy
CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.30
自引率
0.00%
发文量
38
审稿时长
6 weeks
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Cardiology and Therapy is an international, open access, peer reviewed (single-blind), rapid-publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of cardiovascular therapies and interventions, including devices. Studies relating to diagnosis and diagnostics, pharmacoeconomics, public health, quality of life, as well as patient care, management and education are also encouraged.
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