Cardiovascular<i>Z</i>-scores in fetuses with tetralogy of Fallot

Wu, Lie; Wang, N.; Xie, Hong‐Ning; Du, Lixin; Ruan, Peng

doi:10.1002/uog.13419

Cited by 27 publications

(36 citation statements)

References 28 publications

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“…This finding was in contrast to a recently published series of 43 fetuses with tetralogy of Fallot, in which all outflow tract-derived aortic annulus Z scores were greater than 2.0. 22 One explanation for the discrepancies between those results and the results of our study may be the method of Z score calculation, as we used the logarithmic transformation described by Schneider et al 22,24,25 Indeed, the results of other studies, including that of Rollins et al, 20 have also suggested that the aortic annulus Z scores from the outflow tract views ranged widely and were not sensitive markers for tetralogy of Fallot.…”

Section: Discussionmentioning

confidence: 52%

“…This proportion was similar to that reported previously. 22 This finding may have been due to the fact that there is normal variability in the size of main pulmonary artery annulus in early gestation; thus, it may appear to be of normal caliber in fetuses with tetralogy of Fallot at the time of the second-trimester cardiac sonogram. 9 In 2013, the American Institute of Ultrasound in Medicine and other organizations (ie, Society for MaternalFetal Medicine and Society of Radiologists in Ultrasound) adopted the mandatory requirement for attempted visualization of the outflow tracts during basic fetal cardiac sonography.…”

Section: Discussionmentioning

confidence: 99%

“…19 Subsequent articles have further explored the potential of the 3-vessel views to help in the identification of tetralogy of Fallot. 12,[20][21][22] However, these were largely small case series, and they did not address the performance of the 3-vessel and trachea view in comparison to the traditional detection method using the outflow tract view. In this study, we aimed to examine how often the 3-vessel and trachea view was abnormal in pregnancies complicated by tetralogy of Fallot and compare the detection rate with that approach to that of the outflow tract view.…”

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confidence: 99%

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Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Palatnik

Grobman

Cohen

et al. 2016

J of Ultrasound Medicine

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etralogy of Fallot is the most common form of cyanotic congenital heart disease and accounts for 3% to 5% of all congenital heart diseases. 1 The classic anatomic form of tetralogy of Fallot includes a subaortic ventricular septal defect, an aortic root that overrides the ventricular septal defect, infundibular pulmonary stenosis, and concentric right ventricular hypertrophy, with the last feature developing postnatally. More severe forms include right outflow obstruction such as an absent pulmonary valve and pulmonary atresia. Prenatal diagnosis in cases with severe obstruction provides the opportunity to administer early prostaglandin infusion after delivery to maintain ductal patency, thus avoiding life-threatening cyanosis in the early neonatal period. 2 However, the frequency of in utero diagnosis of tetralogy of Fallot has been reported to be only 32% to 47% and varies between different screening centers. [3][4][5][6][7] The contributing factors to the relatively low frequency of prenatal diagnosis are the frequently normal appearance of the 4-chamber view, poor visualization of the outflows tracts, and delay in the evolution of pulmonary atresia, which may only occur in the third trimester. [8][9][10] Anna Palatnik, MD, William A. Grobman, MD, MBA, Leeber S. Cohen, MD, Jeffrey S. Dungan, MD, Nina L. Gotteiner, MD Received September 17, 2015, CASE SERIESPrenatal diagnosis of tetralogy of Fallot remains less frequent compared to other major congenital heart defects. In this study, we examined how often the 3-vessel and trachea view was abnormal in a large series of prenatally diagnosed cases of tetralogy of Fallot. In addition, we compared its sensitivity to that of the traditional outflow tract views for detection of tetralogy of Fallot. We found that both views were abnormal in all fetuses with tetralogy of Fallot, showing reversed aortic-to-pulmonary valve and aortic arch isthmus-to-ductus arteriosus ratios in the outflow tract and 3-vessel and trachea views, respectively. However, as a single measured marker, the enlarged aortic arch isthmus on the 3-vessel and trachea view appears to be the most sensitive for tetralogy of Fallot.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Palatnik

Grobman

Cohen

et al. 2016

J of Ultrasound Medicine

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“…The RV/LV ratio was calculated, and the Z -scores of the RV and LV were calculated for different values of femur length (FL). [67] The number of cases with RV width Z -scores above +2 was calculated for each group. [68] RDH was defined as an RV/LV ratio ≥1.12.…”

Section: Methodsmentioning

confidence: 99%

“…[56] To the best of our knowledge, there are rare studies on evaluating the usefulness of combining the Z -scores of the RV and the RV/LV ratio in fetuses suspected of having RDH. Because the accuracy and prognosis of prenatally diagnosed RDH have been scarcely reported in China, in this retrospective series, we presented information on the components of the prenatal diagnosis, fetal characteristics, clinical associations, and implications for prognosis of consecutively referred cases of fetal RDH over a 7-year period.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Diagnosis of Right Dominant Heart in Fetuses

Feng

Zhu

Liang

et al. 2017

Chinese Medical Journal

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Background:Right dominant heart (RDH) in fetuses can occur with a number of cardiac as well as noncardiac anomalies. Analysis of the enlargement of the right cardiac chamber in the fetus remains a major challenge for sonographers and echocardiographers. The aim of this study was to report the experience with prenatal diagnosis of RDH in the fetuses over a 7-year period.Methods:Fetuses with prenatal diagnosis of RDH from July 2009 to July 2016 were evaluated in two different categories: according to the gestational age, Group I (n = 154, second trimester) and Group II (n = 298, third trimester); and according to the fetal echocardiography diagnosis, Group A (n = 452, abnormal cardiac structure) and Group B (n = 90, normal cardiac structure). Differences in categorical variables were assessed by Chi-square exact test and continuous variables were evaluated by independent Student's t-test or Mann–Whitney U-test depending on parametric or nonparametric nature of the data.Results:Over a 7-year period, 452 fetuses were referred for the assessment of suspected RDH. Left-sided obstructive lesions were observed most frequently in the fetuses with RDH. When comparing Group I with Group II and Group A with Group B, the latter groups exhibited significant differences in the right/left ventricle (RV/LV) ratio (1.435 vs. 1.236, P = 0.002; 1.309 vs. 1.168, P = 0.047), RV width Z-score (1.626 vs. 1.104, P < 0.001; 1.553 vs. 0.814, P = 0.014), and above +2 cutoff percentages (14.3% vs. 22.5%; P = 0.038; 21.5% vs. 12.2%, P = 0.046). Multivariable logistic regression revealed no variables associated with perinatal survival.Conclusions:The study demonstrates that RDH warrants careful attention to the possible presence of a structural cardiac anomaly, especially left-sided obstructive lesions. A diagnosis of RDH is best supported by a combination of the RV Z-score and RV/LV ratio. Most of the fetuses with RDH and structurally normal hearts had favorable outcomes.

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“Y Sign” at the Level of the 3‐Vessel and Trachea View: An Effective Fetal Marker of Aortic Dextroposition Anomalies in the First Trimester

Pasternok¹,

Nocun²,

Knafel

et al. 2017

J of Ultrasound Medicine

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CardiovascularZ-scores in fetuses with tetralogy of Fallot

Abstract: Objective To establish formulae for the calculation of fetal cardiovascular Z-scores based on femur length (FL)

Cited by 27 publications

References 28 publications

Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Prenatal Diagnosis of Right Dominant Heart in Fetuses

“Y Sign” at the Level of the 3‐Vessel and Trachea View: An Effective Fetal Marker of Aortic Dextroposition Anomalies in the First Trimester

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