Prenatal detection of cardiac anomalies in fetuses with single umbilical artery: diagnostic accuracy comparison of maternal-fetal-medicine and pediatric cardiologist.
OBJECTIVE
To determine agreement of cardiac anomalies between maternal fetal medicine (MFM) physicians and pediatric cardiologists (PC) in fetuses with single umbilical artery (SUA).


METHODS
A retrospective review of all fetuses with SUA between 1999 and 2008. Subjects were studied by MFM and PC, delivered at our institution, and had confirmation of SUA and cardiac anomaly by antenatal and neonatal PC follow-up. Subjects were divided into four groups: isolated SUA, SUA and isolated cardiac anomaly, SUA and multiple anomalies without heart anomalies, and SUA and multiple malformations including cardiac anomaly.


RESULTS
39,942 cases were studied between 1999 and 2008. In 376 of 39,942 cases (0.94%), SUA was diagnosed. Only 182 (48.4%) met inclusion criteria. Cardiac anomalies were found in 21% (38/182). Agreement between MFM physicians and PC in all groups combined was 94% (171/182) (95% CI [89.2, 96.8]). MFM physicians overdiagnosed cardiac anomalies in 4.4% (8/182). MFM physicians and PC failed to antenatally diagnose cardiac anomaly in the same two cases.


CONCLUSIONS
Good agreement was noted between MFM physicians and PC in our institution. Studies performed antenatally by MFM physicians and PC are less likely to uncover the entire spectrum of cardiac abnormalities and thus neonatal follow-up is suggested.
Spitalli Universitar Obstetrik-Gjinekologjik "Koco Gliozheni," Bulevardi "Bajram Curri," Tirana, Albania.
Ilir
I
Tasha
Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Rachel
R
Brook
Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Heidi
H
Frasure
Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Noam
0000-0002-8246-7733
N
Lazebnik
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D002309:Cardiology / Q000592:standards*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004452:Echocardiography / Q000592:standards*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D009774:Obstetrics / Q000592:standards*; D010372:Pediatrics / Q000592:standards*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D058529:Single Umbilical Artery / Q000000981:diagnostic imaging*; D016216:Ultrasonography, Prenatal / Q000592:standards*