[Linear insertion of atrioventricular valves (Livav): echocardiographic diagnosis, reliability and prevalence in the general population].
OBJECTIVE
Assess the reliability of prenatal diagnosis of linear insertion of atrioventricular valves (Livav) by echocardiography as well as estimate Livav's prevalence in a population without Down syndrome.


METHODS
One hundred and twenty-three fetuses of whom 113 were explored before and after birth and 631 consecutive out-patients explored in cardiopediatric unit.


METHODS
Determination of the likehood ratio (LHR+ and LHR-) of Livav prenatal diagnosis. Evaluation of the consistency between pre- and postnatal diagnoses as well as between two observers after birth (Kappa index). Prevalence study according to the presence of Down syndrome, cardiac malformation or others abnormalities.


RESULTS
LHR+ value was 6.17 and LHR- value was 0.30 for echographic Livav prenatal diagnosis. Consistency was low between pre- and postnatal diagnoses (Kappa = 0.57) and higher between two observers after birth (Kappa = 0.79). Livav prevalence was 2 to 5% in a population without Down syndrome but 15% when associated with a cardiac malformation. Seventy-eight percent Down syndromes had either Livav or AVSD.


CONCLUSIONS
Livav echographic prenatal diagnosis is difficult, for it generates many false positives. Livav is not specific of Down syndrome and can be found relatively frequently in other subjects.
Néonatalogie-pédiatrie, CHU d'Angers, 49033 Angers cedex 09, France.
C
C
Briennon
F
F
Boussion
M
M
Leblanc-Deshayes
C
C
Lépinard
P
P
Bouye
P
P
Allory
C
C
Savagner
F
F
Biquard
P
P
Pézard
P
P
Descamps
D004314:Down Syndrome / Q000453:epidemiology; D005260:Female; D006351:Heart Valves / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D015995:Prevalence; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal