Impact of a Standardised Fetal Cardiac Screening Programme on Antenatal Detection Rates of Transposition of the Great Arteries

Q3 Medicine
Alison Lee-Tannock, Kate Jardine, Karen Eagleson, Jessica Suna, Kim Betts, Cameron Ward, Benjamin Auld, Alex Gooi
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Abstract

Background

Dextro-transposition of the great arteries (d-TGA) can be difficult to diagnose antenatally. Standardised cardiac screening protocols may improve detection rates.

Aims

The objective of this study was to examine rates of antenatal diagnosis of d-TGA in regional and metropolitan Brisbane over a 10-year period and assess if a targeted antenatal screening education programme had an impact on detection rates.

Materials and Methods

A retrospective cohort study was conducted. Data were collected for infants diagnosed with d-TGA in Queensland between January 2008 and December 2017. Infants were divided into two cohorts to assess antenatal detection rates in both regional and metropolitan areas Queensland pre- and post implementation of a targeted sonographer education programme between 2008 and 2011.

Results

A total of 126 infants were identified with a diagnosis of d-TGA. The overall antenatal detection rate was 63.5% across the 10-year study period. Prior to the educational intervention, the detection rate was 51% (2008–2011 n = 23/45), which increased significantly to 70% post educational intervention (2012–2017, n = 57/81) (p = 0.035). Regional Queensland (n = 60) detection rates increased from 44% to 63% (p = 0.192) and metropolitan (n = 66) detection rates increased from 60% to 76% (p = 0.24) post educational intervention.

Conclusions

Rates of antenatal diagnosis of d-TGA in Queensland compare favourably with internationally published rates, although difficulty in consistently diagnosing this congenital heart defect remains. A targeted educational programme of sonographers performing antenatal screening, particularly in regional areas, appears to increase rates of prenatal diagnosis and improve outcomes.

标准化胎儿心脏筛查方案对大动脉转位产前检出率的影响
背景:大动脉右转位(d-TGA)在产前很难诊断。标准化的心脏筛查方案可以提高检出率。本研究的目的是检查布里斯班地区和大城市10年来d-TGA的产前诊断率,并评估有针对性的产前筛查教育计划是否对诊断率有影响。材料与方法采用回顾性队列研究。收集了2008年1月至2017年12月在昆士兰州诊断为d-TGA的婴儿的数据。婴儿被分为两个队列,以评估2008年至2011年期间昆士兰州区域和大都市地区实施有针对性的超声检查教育计划前后的产前检出率。结果126例患儿被诊断为d-TGA。在10年的研究期间,总体产前检出率为63.5%。教育干预前检出率为51%(2008-2011年n = 23/45),教育干预后检出率为70%(2012-2017年n = 57/81),差异有统计学意义(p = 0.035)。教育干预后,昆士兰地区(n = 60)的检出率从44%增加到63% (p = 0.192),大都市(n = 66)的检出率从60%增加到76% (p = 0.24)。结论:昆士兰州d-TGA的产前诊断率与国际上公布的诊断率相比有利,尽管持续诊断这种先天性心脏缺陷仍然存在困难。对进行产前筛查的超声检查人员,特别是在区域地区开展有针对性的教育方案,似乎可以提高产前诊诊率并改善结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Australasian Journal of Ultrasound in Medicine
Australasian Journal of Ultrasound in Medicine Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
1.90
自引率
0.00%
发文量
40
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