title: Is the addition of the ductus venosus useful when screening for aneuploidy and congenital heart disease in fetuses with normal nuchal translucency?
abstract: OBJECTIVE
  The aim of this study was to examine the possible role of Doppler ultrasound assessment of ductus venosus (DV) blood flow at 11⁺⁰-13⁺⁶ weeks' gestation in fetuses with normal nuchal translucency (NT) in screening for autosomal trisomies (AT) and for congenital heart diseases (CHD) in chromosomally normal fetuses.
  
  
  METHODS
  First-trimester combined screening for trisomy 21 (T21) was carried out prospectively for 7 years in singleton pregnancies. NT and the pulsatility index for DV (DVPI) were calculated. The DV was analyzed according to its association with AT and CHD. The detection rate (DR), false-positive rate (FPR), positive predictive value (PPV), and odds ratio (OR) for abnormal DV were calculated.
  
  
  RESULTS
  Abnormal DV as an early marker of euploid CHD gives a DR of 12.5%, an FPR of 4.3%, a PPV of 1.4%, and a negative predictive value (NPV) of 99.5%, with an OR of 3.1 (95% CI 1.3-7.4). Moreover, abnormal DV as an early marker of AT shows a DR of 35.7%, an FPR of 4.3%, a PPV of 1.2%, an NPV of 99.9%, and an OR of 12.3 (95% CI 4.1-36), and the values are 33.3, 4.3, 0.97, and 99.9% and 11 (95% CI 3.2-36.9), respectively, for T21.
  
  
  CONCLUSIONS
  Our data supports the association between increased DVPI and CHD or AT. The sensitivity of this marker is not strong enough to be used a screening test.
authors.affiliation: Fetal Medicine Service, Department of Obstetrics and Gynecology and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain. pilpra@dexeus.com
authors.forename: Pilar
authors.initials: P
authors.lastname: Prats
authors.forename: Queralt
authors.initials: Q
authors.lastname: Ferrer
authors.forename: Carmina
authors.initials: C
authors.lastname: Comas
authors.forename: Ignacio
authors.initials: I
authors.lastname: Rodríguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000782:Aneuploidy; D004314:Down Syndrome / Q000000981:diagnostic imaging* / Q000196:embryology / Q000453:epidemiology / Q000235:genetics; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D048208:Nuchal Translucency Measurement; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000196:embryology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D011673:Pulsatile Flow; D013030:Spain / Q000453:epidemiology; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult