title: Reference Ranges of Fetal Cardiac Biometric Parameters Using Three-Dimensional Ultrasound with Spatiotemporal Image Correlation M Mode and Their Applicability in Congenital Heart Diseases.
abstract: To determine reference values for fetal heart biometric parameters using the spatiotemporal image correlation (STIC) M mode and their applicability in congenital heart diseases (CHDs). A cross-sectional prospective study was conducted with 300 singleton pregnancies between 20 and 33 + 6 weeks of gestation. Right ventricular wall thickness (RVWT), interventricular septum thickness (IVST), and left ventricular wall thickness (LVWT) were measured off-line using the STIC-M mode with the cursor perpendicular to the interventricular septum. Polynomial regressions adjusted with the coefficient of determination (R2) were performed. The curves were applied to 14 fetuses with structural CHD. For the reproducibility calculations, the concordance correlation coefficient (CCC) was used. The mean RVWT, IVST, and LVWT were 0.34 ± 0.09 cm, 0.28 ± 0.09 cm, and 0.30 ± 0.07 cm, respectively. There was correlation between RVWT, IVST, and LVWT and gestational age (GA): RVWT = -0.002 + 0.013 × GA (R2= 0.33), IVST = -0.011 + 0.011 × GA (R2= 0.25), and LVWT = 0.056 + 0.009 × GA (R2= 0.26). RVWT, IVST, and LVWT were altered (<5th or >95th percentile) in 5/14, 5/14, and 7/14 of the fetuses with CHD, respectively. For RVWT, IVST, and LVWT, intra-observer (CCC = 0.86, 0.85, and 0.87, respectively) and inter-observer (CCC = 0.86, 0.86, and 0.86, respectively) reproducibility were good/moderate. The reference ranges determined for fetal heart biometric parameters using STIC-M had good intra- and inter-observer reproducibility and were applicable to fetuses with CHD.
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Giselle Darahem
authors.initials: GD
authors.lastname: Tedesco
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Marilim
authors.initials: M
authors.lastname: de Souza Bezerra
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Fernanda Silveira Bello
authors.initials: FS
authors.lastname: Barros
authors.affiliation: Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Luciano Marcondes Machado
authors.initials: LM
authors.lastname: Nardozza
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Milene Carvalho
authors.initials: MC
authors.lastname: Carrilho
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Antonio Fernandes
authors.initials: AF
authors.lastname: Moron
authors.affiliation: Department of Maternal and Child, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Francisco Herlânio Costa
authors.initials: FH
authors.lastname: Carvalho
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Liliam Cristine
authors.initials: LC
authors.lastname: Rolo
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil. araujojred@terra.com.br.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D019560:Echocardiography, Three-Dimensional; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D012044:Regression Analysis; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal; D054088:Ventricular Septum / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Congenital heart disease; Fetal heart; Interventricular septum; Reference ranges; Spatiotemporal image correlation; Three-dimensional ultrasound