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World Journal of Pediatrics

, Volume 13, Issue 3, pp 278–281 | Cite as

Factors controlling fetal echocardiography determine the diagnostic accuracy of isolated ventricular septal defect

  • Jiao Chen
  • Liang Xie
  • Han-Min Liu
Brief Report
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Abstract

Background

Fetal echocardiography (FECG) is a key screening tool for prenatal cardiac abnormalities. Herein, we examined the ultrasonic factors determining prenatal ultrasonic diagnosis of isolated ventricular septal defect (IVSD).

Methods

The diagnostic role of ultrasonic factors was investigated in patients in middle or late pregnancy, diagnosed with IVSD by FECG and confirmed using postnatal echocardiography.

Results

One hundred and six patients with IVSD were enrolled; the majority had perimembranous VSD. The combined imaging mode of 2 dimentional-echocardiography (2DE) and color doppler flow imaging (CDFI) showed the highest rate (56.6%) of IVSD detection, while CDFIwas more efficient than 2DE (32.1% vs. 11.3%). The single-view mode was more efficient than multiple-view mode (75.5% vs. 24.5%). The highest efficient mode to detect IVSD was achieved using combined imaging mode on the single view of the left ventricular outflow tract view (LVOTV) (28.3%). FECG correctly classified 71.7% of fetal IVSD. There was a significant difference of accuracy rate in classifying IVSD among the three different imaging modes (χ2=7.141, P<0.05). The single imaging mode of CDFIand the mode of CDFIcombined with 2DE correctly classified 75.9% and 75.0% of fetal IVSD, respectively. LVOTV was the most accurate view of fetal IVSD classification (85.2%; χ2=15.782, P<0.05). There was no difference in accuracies of IVSD classification among multiple-view modes (χ2=2.343, P>0.05) or between single-view mode and multiple-view mode (χ2=0.32, P>0.05).

Conclusion

Single LVOTV in CDFIor CDFIcombined with 2DE of FECG were the most effective diagnostic modes for fetal IVSD diagnosis.

Keywords

congenital heart diseases/defects echocardiography fetal-ultrasound isolated ventricular septal defect 

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References

  1. 1.
    Nayak K, Chandra GSN, Shetty R, Narayan PK. Evaluation of fetal echocardiography as a routine antenatal screening tool for detection of congenital heart disease. Cardiovasc Diagn Ther 2016;6:44–49.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Elliott C. Assessing foetal cardiac anomalies using echocardiography. Eur Heart J 2015;36:1063–1064.PubMedGoogle Scholar
  3. 3.
    Lee G, Fong SX, Salpekar M, Satterwhite CL, Weiner C. Is an isolated ventricular septal defect detected before 24 weeks on ultrasound associated with fetal aneuploidy? J Matern Fetal Neonatal Med 2016;29:1687–1690.CrossRefPubMedGoogle Scholar
  4. 4.
    Lai CW, Chau AK, Lee CP. Comparing the accuracy of obstetric sonography and fetal echocardiography during pediatric cardiology consultation in the prenatal diagnosis of congenital heart disease. J Obstet Gynaecol Res 2016;42:166–171.CrossRefPubMedGoogle Scholar
  5. 5.
    Chiu WH, Hsiung MC, Chen RC, Xiao XM, Wu CL, Tung TH. Prenatal ultrasonography and Doppler sonography for the clinical investigation of isolated ventricular septal defects in a late second-trimester population. Eur J Med Res 2014;19:3.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Du L, Xie HN, Li LJ, Zhu YX, Lin MF, Zheng J. Association between fetal ventricular septal defects and chromosomal abnormalities. Zhonghua Fu Chan Ke Za Zhi 2013;48:805–809. [In Chinese]PubMedGoogle Scholar
  7. 7.
    Wang Y, Wang H, Leng J, Xu M, Liu C, Jin H. Clinical significance of color Doppler echocardiography in diagnosis of fetal simple ventricular septal defect. Chin J Ultrasound Med 2007;23:384–386. [In Chinese]Google Scholar
  8. 8.
    Gao Y, Tang H. Practical echocardiography. Beijing: People’s Military Medical Press, 2011. [In Chinese]Google Scholar
  9. 9.
    Guo N, Zhu Q, Chen J, Yang H. Fetal echocardiography in diagnosis of isolated ventricular septal defect. Chin J Med Imaging Technol 2015;31:1363–1366.Google Scholar
  10. 10.
    Mone F, Walsh C, Mulcahy C, McMahon CJ, Farrell S, Mac Tiernan A, et al. Prenatal detection of structural cardiac defects and presence of associated anomalies: a retrospective observational study of 1262 fetal echocardiograms. Prenat Diagn 2015;35:577–582.CrossRefPubMedGoogle Scholar
  11. 11.
    Zhang X, Ma X, Wang J. The value of echocardiography in diagnosis of fetal ventricular septal defect. Chin J Clin 2013;7:10339–10341. [In Chinese]Google Scholar
  12. 12.
    Cai J, Liu Z, Teng S. The choice and significance of the echocardiographic view of fetal heart in ventricular septal defect diagnosis. Mod Pract Med 2008;20:700–701. [In Chinese]Google Scholar
  13. 13.
    Scott TE, Jones J, Rosenberg H, Thomson A, Ghandehari H, Rosta N, et al. Increasing the detection rate of congenital heart disease during routine obstetric screening using cine loop sweeps. J Ultrasound Med 2013;32:973–979.CrossRefPubMedGoogle Scholar
  14. 14.
    Donofrio MT, Moon-Grady AJ, Hornberger LK, Copel JA, Sklansky MS, Abuhamad A, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014;129:2183–2242.CrossRefPubMedGoogle Scholar
  15. 15.
    Wang J, He Y, Li Z, Liu L, Liu K, Gu X, et al. The study of fetal echocardiography in the localization and quantification of simple ventricular septal defect typing. Chin J Med Ultrasound (Electronic Edi) 2012;9:304–309. [In Chinese]Google Scholar
  16. 16.
    Zhang YF, Zeng XL, Zhao EF, Lu HW. Diagnostic value of fetal echocardiography for congenital heart disease: a systematic review and meta-analysis. Medicine (Baltimore) 2015;94:e1759.CrossRefGoogle Scholar
  17. 17.
    van Velzen CL, Clur SA, Rijlaarsdam ME, Pajkrt E, Bax CJ, Hruda J, et al. Prenatal diagnosis of congenital heart defects: accuracy and discrepancies in a multicenter cohort. Ultrasound Obstet Gynecol 2016;47:616–622.CrossRefPubMedGoogle Scholar
  18. 18.
    Holland BJ, Myers JA, Woods CR. Prenatal diagnosis of critical congenital heart disease reduces risk of death from cardiovascular compromise prior to planned neonatal cardiac surgery: a meta-analysis. Ultrasound Obstet Gynecol 2015;45:631–638.CrossRefPubMedGoogle Scholar
  19. 19.
    Gao JX, Pei QY, Li YT, Yang ZJ. Establishment of a database of fetal congenital heart malformations and preliminary investigation of its clinical application. Taiwan J Obstet Gynecol 2015;54:284–289.CrossRefPubMedGoogle Scholar
  20. 20.
    Satomi G. Guidelines for fetal echocardiography. Pediatr Int 2015;57:1–21.CrossRefPubMedGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Ultrasonography, West China Second University HospitalSichuan UniversityChengduChina
  2. 2.The Vascular Remodeling and Developmental Defects Research Unit, West China Institute of Women and Children’s Health, West China Second University HospitalSichuan UniversityChengduChina
  3. 3.Department of Pediatric Pneumology, West China Second University HospitalSichuan UniversityChengduChina
  4. 4.Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University HospitalSichuan UniversityChengduChina

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