The effectiveness of extended fetal heart screening in a Tertiary Center
Keywords:
Prenatal Diagnosis, Fetal Anomaly, fetal cardiac anomaly, Fetal Echocardiography, Chromosome anomalyAbstract
Our study is to evaluate the effectiveness of extended fetal heart screening in a tertiary center and research the sensitivity, specifity and the positive and negative values of echocardiography.
316 patients who were diagnosed with congenital anomalies among those scanned with the extended fetal heart screening protocol in the perinatology department of our hospital were included in our study. Patients who were not diagnosed with congenital anomalies were excluded. Fetal echocardiographies were perfomed on patients who were admitted to our perinatology clinic, in accordance with the ISUOG extended fetal heart screening protocol.
In our study, 55.3% of all cases with cardiac anomalies are concomitant with extracardiac anomalies. An interventional procedure was performed on 52.5% of the patients for karyotyping purposes. 19.3% was terminated early in the pregnancy, 5% and 12.5% were lost during the intrauterine and neonatal periods, respectively. In our study, upon comparison of the fetal and neonatal results, we determined that the false positive and negative rates for fetal echocardiography were 3.5% and 9.4% respectively.
In our study, the sensitivity, specificity, positive predictive value and accuracy of echocardiography were determined as 91%, 99%, 98% and 99% respectively during the application of ISUOG recommendations in a tertiary center.Downloads
Metrics
References
Manning, FA. Imaging in the diagnosis of fetal anomalies. In: Creasy RK, Resnik R, Editors. Creasy & Resnik’s Maternal Fetal Medicine. 6th ed. Philadelphia: Saunders Elsevier; 2009. p. 275-99.
Gadow, EC. Primary prevention of birth defects. In: Carrera JM, Cabero L, Baraibar R, Editors. The Perinatal Medicine of the New Millenium. Bologna: Monduzzi Ed.; 2001. p. 319-25.
Özler, A., Başaranoğlu, S., Karaçor, T., Yaman Tunç, S., Yaman Tunç, N., Palancı, Y., Evsen, MS., Yalınkaya, A. Tersiyer bir merkezde konjenital anomalili doğumların retrospektif analizi. Perinatoloji Dergisi, 2014;22: 13-17.
Opitz, JM., Wilson, GN., Barness, EG. Abnormalities of blastogenesis, organogenesis, and phenogenesis. In: Barness EG, editor. Potter’s Pathology of the Fetus and Infant. St. Louis: Mosby; 1997. p. 65-102.
Kalter, H. Teratology in the 20th century: environmental causes of congenital malformations in humans and how they were established. Neurotoxicol Teratol, 2003;25: 131-282.
Simpson, JL., Otano, L. Prenatal genetic diagnosis. Gabbe SG, Niebly JR, Simpson JL (Eds). Obstetrics: Normal and Problem Pregnancy Churchill Livingstone, Elsevier, 5. Baskı, 2007; Bölüm 7: 152-183
Salomon, LJ., Alfirevic, Z., Berghella, C., Bilardo, E., Hernandez-Andrade, E., Johnsen, SL., Kalache, K., et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol, 2011; 37: 116-26.
Tomatir, AG., Demirhan, H., Sorkun, HC., Köksal, A., Ozerdem, F., Cilengir, N. Major congenital anomalies: a five-year retrospective regional study in Turkey. Genet Mol Res, 2009; 8: 19-27.
Kurdoğlu, M., Kuroğlu, Z., Küçükaydın, Z., Kolusar,ı A., Adalı, E., Yıldızhan, R. et. al. Van yöresinde konjenital malformasyonların görülme sıklığı ve dağılımı. Van Tıp Dergisi, 2009; 16: 95-8.
Chen, M., Lee, CP., Lam, YH., Tang, RYK., Chan, BCP., Wong, SF., Tse, LHY., Tang, MHY. Comparison of nuchal and detailed morphology ultrasound examinations in early pregnancy for fetal structural abnormality screening: a randomized controlled trial. Ultrasound Obstet Gynecol, 2008; 31: 136–146.
Iliescu, D., Tudorache, S., Comanescu, A., Antsaklis, P., Cotarcea, S., Novac, L., Cernea N, Antsaklis A. Improved detection rate of structural abnormalities in the first trimester using an extended examination protocol. Ultrasound Obstet Gynecol, 2013; 42: 300-9.
Haak, MC., Twisk, .J, Van Vugy, JMG. How successful is fetal echocardiographic examination in the first trimester of pregnancy? Ultrasound Obstet Gynecol, 2002; 20: 9-13.
Güven, MA., Günhan, Ö., Coskun, A. 12. gebelik haftasında artmış NT ve Heart anomalisi bulguları ile prezente olan Trizomi 18 olgusu. Perinatoloji Dergisi, 2007; 15: 87-91.
Güven, MA., Carvalho, J., Ho, Y., Shinebourne, E. Sequential segmental analysis of the heart. Artemis, 2003; 4: 21- 3.
Dashe, J., McIntire, D., Ramus, R., Santos-Ramos, R., Twickler, D. Hydramnios: anomaly prevalence and sonographic detection. Obstet Gynecol, 2002; 100: 134- 9.
Bahado-Singh, RO., Rowther, M., Bailey, J. Midtrimester nuchal thickness and the prediction of postnatal congenital heart defect. Am J Obstet Gynecol, 2002; 187: 1137- 42.
Timur, A., Uyar, İ., Gülhan, İ., Tan Saz, N., İleri, A., Özeren, M. Genetik amniyosentez yapılan 16-22 haftalık gebelerin amniyosentez sonuçlarının değerlendirilmesi. Perinatoloji Dergisi, 2013; 21(4): 101-154
Dağlar, HK., Kaya, B., Şahin, HÖ., Pınar, MF., Akıl, A. Gaziantep İli Doğum Hastanesi’nde Karyotip Analizi Amacı ile Amniyosentez ve Koryon Villus Örneklemesi Yapılan 268 Olgunun Retrospektif Analizi. Perinatoloji Dergisi, 2011; 19(3): 130-136.
Yıldırım, G., Aslan, H., Gül, A., Güngördük, K., Aktaş, FN., Çakmak, D., Ceylan, Y. İkinci Trimester Genetik Amniyosentez Sonrası Gebelik Sonuçları: 1070 Olgunun Değerlendirmesi. Perinatoloji Dergisi, 2006; 14(3): 129-134.
Pala, HG., Artunç Ülkümen, B., Eskicioğlu, F., Uluçay, S., Çam, S., Bülbül Baytur, Y., Koyuncu, FM. Manisa İli Üçüncü Basamak 2012 Yılı Amniyosentez Sonuçları. Perinatoloji Dergisi, 2014; 22(1): 1-61.
Song, MS., Hu, A., Dyamenahalli, U., Chitayat, D., Winsor, EJ., Ryan, G. et al. Extracardiac lesions and chromosomal abnormalities associated with major fetal heart defects: comparison of intrauterine, postnatal and postmortem diagnoses. Ultrasound Obstet Gynecol, 2009; 33(5): 552-9.
Ozkutlu, S., Saraçlar, M. The accuracy of antenatal fetal echocardiography. Turk J Pediatr, 1999; 41(3): 349-52.
Strauss, A., Toth, B., Schwab, B., Fuchshuber, S., Schulze, A., Netz, H., Hepp, H. Prenatal diagnosis of congenital heart disease and neonatal outcome--a six years experience. Eur J Med Res, 2001, 28: 6(2): 66-70.
Srinivasan, S. Fetal echocardiography. Indian J Pediatr, 2000, 67(7): 515-21.
Downloads
Published
How to Cite
Issue
Section
License
Authors can retain copyright, while granting the journal right of first publication. Alternatively, authors can transfer copyright to the journal, which then permits authors non-commercial use of the work, including the right to place it in an open access archive. In addition, Creative Commons can be consulted for flexible copyright licenses.
©1999 Creative Commons Attribution-ShareAlike 4.0 International License.