A systematic review of the accuracy of first‐trimester ultrasound examination for detecting major congenital heart disease

Rasiah, SV; Publicover, Mary; Ewer, Andrew K; Khan, Khalid S.; Kilby, Mark; Zamora, Javier

doi:10.1002/uog.2803

Cited by 111 publications

(108 citation statements)

References 37 publications

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“…• Optimization of health conditions pre-conception • Reassessment of treatment plan, considering the potential for disease exacerbations from pregnancy, teratogenicity of medications, patient non-adherence, and negative maternal and fetal consequences of untreated morbidities (Negro and Mestman 2011;Seeman 2013;Thorne 2004) • Antenatal care, delivery, neonatal evaluation, and postpartum care in a high-risk obstetric center with an experienced multidisciplinary team Hatton et al 2012;Seeman 2013) • Appropriate screening during pregnancy, including early fetal echocardiogram to screen for congenital heart disease (Rasiah et al 2006) Social support • Awareness of potential sources of conflict between patient and partner/family (Finucane 2010;Karas et al 2014) • Tailoring of support based on the individual patient's needs and his/her existing supports (e.g., social work, child care resources, child protection services, financial resources) (Butcher et al 2012;Finucane 2010;Karas et al 2014) Sexual and reproductive health…”

Section: Issue Suggested Management Strategies To Considermentioning

confidence: 99%

Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome

Chan

Costain

Ogura

et al. 2015

Journal of Genetic Counseling

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Correspondence to: Anne S. Bassett. Conflict of Interest StatementsChrystal Chan, Gregory Costain, Lucas Ogura, Candice K. Silversides, Eva W.C. Chow, and Anne S. Bassett declare that they have no conflict of interest.Human Studies and Informed Consent All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study. .2DS, compared with expectations for the general population, showed a significantly elevated prevalence of small for gestational age liveborn offspring (p<0.001), associated mainly with infants with 22q11.2DS. Stillbirths also showed elevated prevalence (p<0.05). Not all observed adverse events appeared to be attributable to transmission of the 22q11.2 deletion. Recurring issues relevant to reproductive health in 22q11.2DS included the potential impact of maternal morbidities, inadequate social support, unsafe sexual practices, and delayed diagnosis of 22q11.2DS and/or lack of genetic counseling. These preliminary results emphasize the importance of early diagnosis and long term follow-up that could help facilitate genetic counseling for men and women with 22q11.2DS. We propose initial recommendations for pre-conception management, educational strategies, pre-natal planning, and preparation for possible high-risk pregnancy and/or delivery. Animal Studies

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Section: Issue Suggested Management Strategies To Considermentioning

confidence: 99%

Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome

Chan

Costain

Ogura

et al. 2015

Journal of Genetic Counseling

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“…Tegnander et al [48] reported that sonographers with previous experience of more than 2,000 examinations of the fetal heart had a 52% detection rate of CHD as compared to a 32.5% detection rate of operators performing fewer than 2,000 cardiac examinations. Rasiah et al [49] performed a systematic review of the diagnostic performance of fetal echocardiography in the first trimester of pregnancy. They identified 10 studies conducted in tertiary centers with good quality control and reported a combined sensitivity of 85% (95% CI 78-90%) and specificity of 99% (95% CI 98-100%), a positive likelihood ratio (LR) of 59.6 (95% CI 26.5-133.6), and a negative LR of 0.25 (95% CI 0.1-0.6) for the identification of CHD.…”

Section: Operator Experience and Route Of Ultrasound Examinationmentioning

confidence: 99%

Early Evaluation of the Fetal Heart

et al. 2017

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Evaluation of the fetal heart at 11-13 + 6 weeks of gestation is indicated for women with a family history of congenital heart defects (CHD), a previous child with CDH, or an ultrasound finding associated with cardiac anomalies. The accuracy for early detection of CHD is highly related to the experience of the operator. The 4-chamber view and outflow tracts are the most important planes for identification of an abnormal heart, and can be obtained in the majority of fetuses from 11 weeks of gestation onward. Transvaginal ultrasound is the preferred route for fetal cardiac examination prior to 12 weeks of gestation, whereas, after 12 weeks, the fetal heart can be reliably evaluated by transabdominal ultrasound. Cardiac defects, such as ventricular septal defects, tetralogy of Fallot, Ebstein's anomaly, or cardiac tumors, are unlikely to be identified at ≤14 weeks of gestation. Additional ultrasound techniques such as spatiotemporal image correlation and the evaluation of volumes by a fetal-heart expert can improve the detection of congenital heart disease. The evaluation of the fetal cardiac function at 11-13 + 6 weeks of gestation can be useful for early identification of fetuses at risk of anemia due to hemoglobinopathies, such as hemoglobin Bart's disease.

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“…Esta evaluación está limitada por la escasez de médicos especialistas cualificados que pueden interpretar estos ultrasonidos. Un estudio piloto con los operadores no expertos a través de un enlace de telemedicina demostró que este examen era técnicamente factible 36 .…”

Section: Ventajas Y Desventajas Del Uso De Tic En Obstetriciaunclassified

Uso de las tecnologías de información y comunicación para el cuidado del binômio materno-fetal: revisión de tema

Gomez¹,

Silva²,

Correa³

et al. 2015

MedUPB

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A systematic review of the accuracy of first‐trimester ultrasound examination for detecting major congenital heart disease

Cited by 111 publications

References 37 publications

Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome

Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome

Early Evaluation of the Fetal Heart

Uso de las tecnologías de información y comunicación para el cuidado del binômio materno-fetal: revisión de tema

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