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Am J Obstet Gynecol. 1995 Jun;172(6):1741-7; discussed 1747-9.

The accuracy of antenatal fetal echocardiography screening in high- and low-risk patients.

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1
Department of Obstetrics and Gynecology, Saint John's Mercy Medical School, Saint Louis, MO, USA.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the accuracy of four-chamber and left ventricular outflow tract views in low-risk patients and comprehensive fetal echocardiographic examinations in high-risk patients to diagnose structural heart disease or thoracic anomalies.

STUDY DESIGN:

A prospective outcome study of two cohorts was performed; 1136 low-risk patients and 886 high-risk patients were evaluated during a 2-year period. Low-risk patients underwent routine four-chamber and left ventricular outflow tract evaluation whereas high-risk patients had detailed fetal echocardiographic examinations. Accuracy of the ultrasonographic diagnosis was evaluated from neonatal discharge data.

RESULTS:

Only 2 of 14 patients with congenital heart disease in the low-risk group were correctly identified (sensitivity 14.3%) whereas 10 of 16 patients with congenital heart disease or thoracic anomalies were correctly identified in the high-risk group (sensitivity 62.5%).

CONCLUSION:

The current study showed poor diagnostic accuracy of the standard four-chamber and left ventricular outflow tract views in low-risk patients for the diagnosis of structural cardiac anomalies. Patients with risk factors for congenital heart disease should be referred for comprehensive fetal echocardiographic examination.

PMID:
7778627
[Indexed for MEDLINE]
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