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Identification of fetal cardiac anatomy and hemodynamics: a novel enhanced screening protocol.

Authors :
Ying Zhang
Ai-Lu Cai
Wei-dong Ren
Ya-Jun Guo
Dong-yu Zhang
Wei Sun
Yu Wang
Lei Wang
Yue Qin
Li-ping Huang
Zhang, Ying
Cai, Ai-Lu
Ren, Wei-Dong
Guo, Ya-Jun
Zhang, Dong-Yu
Sun, Wei
Wang, Yu
Wang, Lei
Qin, Yue
Huang, Li-Ping
Source :
BMC Pregnancy & Childbirth; 6/30/2016, Vol. 16, p1-13, 13p
Publication Year :
2016

Abstract

<bold>Background: </bold>Prenatal cardiac screening is of great importance as it contributes to appropriate neonatal management and helps parents to make a decision regarding their pregnancy. The aim of our study was to evaluate the efficiency of a newly proposed screening protocol in the detection of fetal congenital heart disease (CHD).<bold>Methods: </bold>This was a prospective study. A total of 52 cases of confirmed CHD fetuses and 248 cases of randomly selected normal fetuses were included in the study. Two sonographers with similar experience performed the cardiac screenings under two different protocols independently. The conventional protocol (Protocol A) paid greater attention to the four-chamber view and the outflow tract views. A 6-month training program was provided to sonographers performing scans under the new protocol (Protocol B), which emphasized systematically evaluating fetal cardiac anatomy and hemodynamics. Color Doppler was mandatory and some ultrasonic signs for special cardiac anomalies were also introduced into this protocol.<bold>Results: </bold>Protocol B detected more cardiac anomalies than did Protocol A (96.2 % vs. 61.5 %, Pā€‰<ā€‰0.01). Specifically, Protocol B was superior to Protocol A in detecting cardiac malpositions, abnormal systemic and pulmonary venous connection, right aortic arch, transposition of the great arteries, and congenital corrected transposition of the great arteries. By visualizing flow disturbance and retrograde flow with color Doppler, Protocol B was better than Protocol A in screening valvular associated malformations, such as pulmonary atresia, pulmonary stenosis, tricuspid dysplasia, etc. For the normal fetuses, Protocol B was better than Protocol A in reducing the false-positive detection of septal defects.<bold>Conclusions: </bold>The current study introduces an enhanced protocol for fetal cardiac screening, under which the obstetric screening sonographers systematically identify fetal cardiac anatomy and hemodynamics. A short-term training program makes it possible for the screening sonographers to become familiar with the new protocol, and its value has been confirmed due to improvements made in screening efficiency. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14712393
Volume :
16
Database :
Complementary Index
Journal :
BMC Pregnancy & Childbirth
Publication Type :
Academic Journal
Accession number :
116658123
Full Text :
https://doi.org/10.1186/s12884-016-0933-9