title: Quantitative Cardiac Assessment in Fetal Tetralogy of Fallot.
abstract: OBJECTIVE
  The purpose of this study was to quantitatively assess cardiac function and biometric parameters in fetuses with a diagnosis of tetralogy of Fallot and compare them to those in healthy fetuses.
  
  
  METHODS
  Two hundred healthy fetuses and 20 fetuses with a diagnosis of classic tetralogy of Fallot were quantitatively assessed for 16 cardiac parameters, including morphologic characteristics and functions. All recruited fetuses were in the second trimester with correct gestational ages. The measured values that were out of normal reference ranges were considered abnormal. Rates of abnormalities of these parameters were compared between the groups. The significant parameters were further analyzed for their sensitivity, specificity, and likelihood ratio.
  
  
  RESULTS
  Of the 16 parameters, rates of abnormalities in 7 parameters, including right ventricular wall thickness, peak systolic velocities (PSVs) in the pulmonary artery and aorta, time to peak velocity, or acceleration time, in the pulmonary artery, aortic valve diameter, pulmonary valve diameter, and aortic-to-pulmonary valve diameter ratio, were significantly higher in fetuses with tetralogy of Fallot (P < .001). The pulmonary artery PSV, pulmonary artery time to peak velocity, aortic valve diameter, pulmonary valve diameter, and aortic-to-pulmonary valve diameter ratio had high sensitivities (80.0%, 75.0%, 90.0%, 90.0%, and 100.0%, respectively) and specificities (95.5%, 97.0%, 94.5%, 96.0%, and 84.5%).
  
  
  CONCLUSIONS
  In addition to a routine anatomic examination, quantitative assessment of fetal hemodynamics, especially an abnormally high PSV in the pulmonary artery, as well as a shortened acceleration time and abnormal valve size, might be very helpful for confirmation of the diagnosis in cases of suspected tetralogy of Fallot.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Phudit
authors.initials: P
authors.lastname: Jatavan
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Fuanglada
authors.initials: F
authors.lastname: Tongprasert
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Kasemsri
authors.initials: K
authors.lastname: Srisupundit
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Suchaya
authors.initials: S
authors.lastname: Luewan
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Kuntharee
authors.initials: K
authors.lastname: Traisrisilp
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ttongson@mail.med.cmu.ac.th.
authors.forename: Theera
authors.initials: T
authors.lastname: Tongsong
mesh_terms: D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D011247:Pregnancy; D015203:Reproducibility of Results; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: cardiac function; fetal echocardiography; fetus; prenatal diagnosis; tetralogy of Fallot