Efficacy of routine fetal ultrasound screening for congenital heart disease in Isère county, France

Klein, Saskia K.; Cans, Chantal; Robert, Elisabeth; Jouk, Pierre‐Simon

doi:10.1002/(sici)1097-0223(199904)19:4<318::aid-pd538>3.0.co;2-x

Cited by 38 publications

(20 citation statements)

References 9 publications

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“…Most of the published literature comes from European countries, which tend to have more centralized healthcare systems and uniform practices vis-à-vis prenatal ultrasound. 30,[37][38][39][40][41] As such, these systems may represent the best-case scenario for population prenatal ultrasound screening. In the United States, many congenital surgery referral centers have reported prenatal detection rates Ͼ50% for functional single-ventricle lesions, 35,42 although the detection rate is generally Ͻ30% for CCHD lesions with 2-ventricle circulation.…”

Section: Customary Practicementioning

confidence: 99%

Role of Pulse Oximetry in Examining Newborns for Congenital Heart Disease

Mahle¹,

Newburger²,

Matherne³

et al. 2009

Circulation

246

134

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Background-The purpose of this statement is to address the state of evidence on the routine use of pulse oximetry in newborns to detect critical congenital heart disease (CCHD). Methods and Results-A writing group appointed by the American Heart Association and the American Academy of Pediatrics reviewed the available literature addressing current detection methods for CCHD, burden of missed and/or delayed diagnosis of CCHD, rationale of oximetry screening, and clinical studies of oximetry in otherwise asymptomatic newborns. MEDLINE database searches from 1966 to 2008 were done for English-language papers using the following search terms: congenital heart disease, pulse oximetry, physical examination, murmur, echocardiography, fetal echocardiography, and newborn screening. The reference lists of identified papers were also searched. Published abstracts from major pediatric scientific meetings in 2006 to 2008 were also reviewed. The American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. In an analysis of pooled studies of oximetry assessment performed after 24 hours of life, the estimated sensitivity for detecting CCHD was 69.6%, and the positive predictive value was 47.0%; however, sensitivity varied dramatically among studies from 0% to 100%. False-positive screens that required further evaluation occurred in only 0.035% of infants screened after 24 hours. Conclusions-Currently, CCHD is not detected in some newborns until after their hospital discharge, which results in significant morbidity and occasional mortality. Furthermore, routine pulse oximetry performed on asymptomatic

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Section: Customary Practicementioning

confidence: 99%

Role of Pulse Oximetry in Examining Newborns for Congenital Heart Disease

Mahle¹,

Newburger²,

Matherne³

et al. 2009

Circulation

246

134

View full text Add to dashboard Cite

show abstract

“…There is, however, regional variation in prenatal detection of CHD, with those obstetric centres close to cardiac units faring better than those situated in more remote areas (Allan et al, 1994;Bull, 1999). In screening programmes, detection rates of CHD are significantly higher if extra-cardiac malformations are present (48 vs 25% (Klein et al, 1999)) because these increase the suspicion of aneuploidy and prompt a more detailed ultrasound survey. In one series, 98% of aneuploid fetuses with CHD had extra-cardiac malformations (Tennstedt et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Congenital heart disease and aneuploidy

Wimalasundera

Gardiner

2004

Prenatal Diagnosis

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Congenital heart disease (CHD) is one of the commonest prenatal diagnoses made on routine ultrasound screening. Overall, up to 33% of CHD are associated with fetal aneuploidy. However, some specific cardiac lesions have a significantly greater association with particular chromosomal abnormalities. The majority of fetuses with CHD and aneuploidy also have extra-cardiac anomalies and are best managed by a multidisciplinary team where the management and prognosis of the cardiac defect can be discussed in the context of the baby as a whole. It is therefore important for clinicians involved in the management of fetuses with CHD to be aware of the association of aneuploidy as well as the prognosis and management of these cases, so that they can appropriately counsel the parents. In this chapter, we review the frequency and types of aneuploidy associated with the commonly diagnosed CHD and discuss their management.

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“…Несмотря на развитие детской кардиологии и кардиохирургии как области практической медицины, за последние 10-15 лет диагности-ка критических и сложно-комбинированных врожденных пороков сердца, не установленных на пренатальном этапе [6,[7][8][9][10][11], остается слож-ной задачей для неонатальных служб. Во многом такая ситуация обусловлена отсутствием в их ар-сенале доступной экспертной эхокардиографии.…”

Section: Discussionunclassified

The role of pulse oximetry in neonatal screening for critical and complex congenital heart defects

et al. 2017

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Актуальность. Своевременная диагности-ка сложно-комбинированных и критических врожденных пороков сердца периода ново-рожденности позволяет избежать фаталь-ных осложнений их естественного течения и выстроить правильную лечебную тактику. В этой связи важно иметь во врачебном арсе-нале доступные, недорогие методы скрининга для рутинной диагностики. Цель -показать возможности пульсоксиметрии в диагности-ке сложно-комбинированных и критических врожденных пороков сердца. Материал и ме-тоды. В исследование вошли 46 новорожден-ных в возрасте от 1 до 27 дней с постнатально установленным врожденным пороком сердца. Диагноз верифицирован данными экспертной эхокардиографии, показанием для выпол-нения которой был положительный пульсо-ксиметрический тест либо необъяснимая за-висимость от кислорода и/или клиническая картина тяжелой сердечной недостаточности. Пульсоксиметрический тест считался положи-тельным при SaO 2 < 95% на любой конечности и при разнице показателей SaO 2 между правой рукой и ногой более 3%. Результаты. У всех младенцев с транспозицией магистральных артерий (n = 5), синдромом гипоплазии левого сердца (n = 6), тотальным аномальным дрена-жем легочных вен (n = 2), общим артериальным стволом (n = 3), атрезией легочной артерии с дефектом межжелудочковой перегородки (n = 1) пульсоксиметрический тест оказался положительным. Отсутствие информативности пульсоксиметрического теста при обструк-тивных поражениях левого сердца было заре-гистрировано у пациентов со стенозом кла-пана аорты и ее коарктацией. Заключение. Пульсоксиметрический тест может быть ис-пользован как метод рутинного скрининга на сложно-комбинированные и критические врожденные пороки сердца периода новоро-жденности.Ключевые слова: критические врожденные пороки сердца, диагностика критических врожденных пороков сердца, пульсоксиметри-ческий тест

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Efficacy of routine fetal ultrasound screening for congenital heart disease in Isère county, France

Cited by 38 publications

References 9 publications

Role of Pulse Oximetry in Examining Newborns for Congenital Heart Disease

Role of Pulse Oximetry in Examining Newborns for Congenital Heart Disease

Congenital heart disease and aneuploidy

The role of pulse oximetry in neonatal screening for critical and complex congenital heart defects

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