Length to width ratio of the ductus venosus in simple screening for fetal congenital heart diseases in the second trimester.
Antenatal diagnosis of congenital heart disease (CHD) is still low even though screening was first introduced over 25 years ago. The purpose of our study was to determine the efficacy of a second-trimester prenatal ultrasonographic method of screening for CHD.From September 2012 to September 2013, the length and width of the fetal ductus venosus were measured sonographically in 1006 singleton fetuses, and the ratio of length to width was calculated. The accuracy of each fetal measurement and Doppler ultrasonography were determined. The standard fetal echocardiographic evaluations including 2-dimensional gray-scale imaging, color, and Doppler color flow mapping were performed. The transducer was aligned to the long axis of the fetal trunk to view the ductus venosus in its full length, including the inlet (isthmus) and outlet portions of the vessel. The diameters of the vessel inner wall and mid-point of the ductus venosus were measured using calipers. All scans and fetal measurements were conducted by a registered sonographer with more than 20 years of perinatal ultrasound screening experience.Of the 1006 singleton fetuses between 19 and 28 weeks' gestation, 36 had CHD. The ductus venosus length/width ratio (DVR) for the first CHD screening was extremely sensitive at 88.90%, with a specificity of 99.10% for the cardiac abnormalities included in this study. Chromosomal anomalies accompanied CHD in 0.4% (4/1006) of all cases and 11.11% (4/36) of the CHD cases.The DVR differed significantly between fetuses with CHD and normal fetuses during the second trimester. Careful assessment of the ratio should be a part of the sonographic examination of every fetus. In the case of a small DVR, advanced echocardiography and karyotype analysis should be performed. The ratio is a helpful tool for screening CHD abnormalities prenatally in the Chinese population.
aDepartment of Biomedical Imaging and Radiological Sciences, School of Biomedical Science and Engineering, National Yang-Ming University bDepartment of Obstetrics and Gynecology, Chung Shan Hospital, Taipei cDepartment of Obstetrics and Gynecology, Hungchi Women & Children's Hospital, Taoyuan, Taiwan dDepartment of Obstetrics and Gynecology, Changsha Anzhen Women Hospital, Changsha, China eFu-Jen Catholic University fDepartment of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan gDepartment of Obstetrics and Gynecology, the 1st Affiliated Hospital, Jinan University, Guangzhou, China.
Wei-Hsiu
WH
Chiu
Shy-Ming
SM
Lee
Tao-Hsin
TH
Tung
Xiao-Mei
XM
Tang
Ren-Shyan
RS
Liu
Ran-Chou
RC
Chen
D000293:Adolescent; D000328:Adult; D003331:Coronary Vessels / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000196:embryology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005333:Fetus; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D009929:Organ Size; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000196:embryology; D055815:Young Adult
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