Authors: I Durand G Deverriere C Thill A S Lety C Parrod N David E Barre T Hazelzet
Publish Date: 2015/04/07
Volume: 36, Issue: 6, Pages: 1248-1254
Abstract
The objective of this study was to assess the ability of different parameters to identify fetuses requiring neonatal care for coarctation of the aorta CoA Between January 2003 and December 2012 175 fetuses referred for great vessel disproportion were divided into two groups group A n = 51 with high risk of CoA and delivery planned in tertiary care referral center and group B n = 124 with no increased risk of CoA In group A diagnosis of CoA was confirmed in 38/51 74 In group B 2/124 had CoA Multiple logistic regression analysis identified the best combination as diffusely hypoplastic and/or angular aortic arches ventricular septal defect and aortic valve diameter 5 mm at 36week gestational age GA Positive predictive value was 75 when vessel disproportion was noted before 28week GA and 73 in the third trimester Postnatal diagnosis involved 38 cases of CoA which had not been referred One case of CoA diagnosed after birth was referred prenatally for difficulty of screening without any defect The results of our prospective study are in agreement with those of previous series but our false positive rate was lower especially when the diagnosis of vascular disproportion was made at third trimester The performance of fetal cardiac screening does not seem to be very good but prenatal diagnosis is probably not always possible Among our three false negative cases two had isolated vascular disproportion and the third no risk factors
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