The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease
Abstract Introduction Fetal echocardiograms (F-echo) are recommended in all pregnancies when maternal congenital heart disease (CHD) is present, even if there was a prior level II ultrasound (LII-US) that was normal. The goal of this study was to evaluate if any diagnosis of a critical CHD was misse...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2024-01-01
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| Series: | Cardiology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40119-024-00350-z |
| _version_ | 1797272853476802560 |
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| author | Sophia Calcara Amanda Paeltz Bernadette Richards Tracey Sisk Corey Stiver Oluseyi Ogunleye Karen Texter May Ling Mah Clifford L. Cua |
| author_facet | Sophia Calcara Amanda Paeltz Bernadette Richards Tracey Sisk Corey Stiver Oluseyi Ogunleye Karen Texter May Ling Mah Clifford L. Cua |
| author_sort | Sophia Calcara |
| collection | DOAJ |
| description | Abstract Introduction Fetal echocardiograms (F-echo) are recommended in all pregnancies when maternal congenital heart disease (CHD) is present, even if there was a prior level II ultrasound (LII-US) that was normal. The goal of this study was to evaluate if any diagnosis of a critical CHD was missed in a fetus with maternal CHD who had a normal LII-US. Methods A retrospective chart review of all F-echoes where the indication was maternal CHD between 1/1/2015 to 12/31/2022 was performed. Fetuses were included if they had a LII-US that was read as normal and had an F-echo. Critical CHD was defined as CHD requiring catheterization or surgical intervention < 1 month of age. Results A total of 296 F-echoes on fetuses with maternal CHD were evaluated, of which 175 met inclusion criteria. LII-US was performed at 19.8 ± 2.9 weeks gestational age and F-echo was performed at 24.2 ± 2.8 weeks gestational age. No patient with a normal LII-US had a diagnosis of a critical CHD by F-echo (negative predictive value = 100%). Evaluating those patients that had a negative LII-US, ten patients were diagnosed with non-critical CHD postnatally (negative predictive value = 94.3%). F-echo correctly diagnosed two of the ten missed LII-US CHD. Conclusions Critical CHD was not missed with a normal LII-US in this at risk population. F-echo also missed the majority of CHD when a LII-US was read as normal. A cost–benefit analysis of screening F-echo in fetuses with maternal CHD should be conducted if a normal LII-US has been performed. |
| first_indexed | 2024-03-07T14:36:15Z |
| format | Article |
| id | doaj.art-cf852ebc7e374f4ab4862f479d0af52a |
| institution | Directory Open Access Journal |
| issn | 2193-8261 2193-6544 |
| language | English |
| last_indexed | 2024-03-07T14:36:15Z |
| publishDate | 2024-01-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Cardiology and Therapy |
| spelling | doaj.art-cf852ebc7e374f4ab4862f479d0af52a2024-03-05T20:40:52ZengAdis, Springer HealthcareCardiology and Therapy2193-82612193-65442024-01-0113116317110.1007/s40119-024-00350-zThe Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart DiseaseSophia Calcara0Amanda Paeltz1Bernadette Richards2Tracey Sisk3Corey Stiver4Oluseyi Ogunleye5Karen Texter6May Ling Mah7Clifford L. Cua8Heart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalHeart Center, Nationwide Children’s HospitalAbstract Introduction Fetal echocardiograms (F-echo) are recommended in all pregnancies when maternal congenital heart disease (CHD) is present, even if there was a prior level II ultrasound (LII-US) that was normal. The goal of this study was to evaluate if any diagnosis of a critical CHD was missed in a fetus with maternal CHD who had a normal LII-US. Methods A retrospective chart review of all F-echoes where the indication was maternal CHD between 1/1/2015 to 12/31/2022 was performed. Fetuses were included if they had a LII-US that was read as normal and had an F-echo. Critical CHD was defined as CHD requiring catheterization or surgical intervention < 1 month of age. Results A total of 296 F-echoes on fetuses with maternal CHD were evaluated, of which 175 met inclusion criteria. LII-US was performed at 19.8 ± 2.9 weeks gestational age and F-echo was performed at 24.2 ± 2.8 weeks gestational age. No patient with a normal LII-US had a diagnosis of a critical CHD by F-echo (negative predictive value = 100%). Evaluating those patients that had a negative LII-US, ten patients were diagnosed with non-critical CHD postnatally (negative predictive value = 94.3%). F-echo correctly diagnosed two of the ten missed LII-US CHD. Conclusions Critical CHD was not missed with a normal LII-US in this at risk population. F-echo also missed the majority of CHD when a LII-US was read as normal. A cost–benefit analysis of screening F-echo in fetuses with maternal CHD should be conducted if a normal LII-US has been performed.https://doi.org/10.1007/s40119-024-00350-zFetal screeningFetal echocardiogramCongenital heart diseaseMaternal congenital heart disease |
| spellingShingle | Sophia Calcara Amanda Paeltz Bernadette Richards Tracey Sisk Corey Stiver Oluseyi Ogunleye Karen Texter May Ling Mah Clifford L. Cua The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease Cardiology and Therapy Fetal screening Fetal echocardiogram Congenital heart disease Maternal congenital heart disease |
| title | The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease |
| title_full | The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease |
| title_fullStr | The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease |
| title_full_unstemmed | The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease |
| title_short | The Utility of Screening Fetal Echocardiograms Following Normal Level II Ultrasounds in Fetuses with Maternal Congenital Heart Disease |
| title_sort | utility of screening fetal echocardiograms following normal level ii ultrasounds in fetuses with maternal congenital heart disease |
| topic | Fetal screening Fetal echocardiogram Congenital heart disease Maternal congenital heart disease |
| url | https://doi.org/10.1007/s40119-024-00350-z |
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