Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Abstract Objective To evaluate the accuracy of the diagnosis of fetal heart diseases obtained through ultrasound examinations performed during the prenatal period compared with the postnatal evaluation. Methods A retrospective cohort study with 96 pregnant women who were attended at the Echocardiography Service and whose deliveries occurred at the Complexo Hospitalar Santa Casa de Porto Alegre, in the state of Rio Grande do Sul, Brazil. Risk factor assessment plus sensitivity and specificity analysis were used, comparing the accuracy of the screening for congenital heart disease by means of obstetrical ultrasound and morphological evaluation and fetal echocardiography, considering p < 0.05 as significant. The present study was approved by the Research Ethics Committee of the Institution. Results The analysis of risk factors shows that 31.3% of the fetuses with congenital heart disease could be identified by anamnesis. The antepartum echocardiography demonstrated a sensitivity of 97.7%, a specificity of 88.9%, and accuracy of 93% in the diagnosis of congenital heart disease. A sensitivity of 29.3% was found for the obstetric ultrasound, of 54.3% for themorphological ultrasound, and of 97.7% for the fetal echocardiography. The fetal echocardiography detected fetal heart disease in 67.7% of the cases, the morphological ultrasound in 16.7%, and the obstetric ultrasound in 11.5% of the cases. Conclusion There is a high proportion of congenital heart disease in pregnancies with no risk factors for this outcome. Faced with the disappointing results of obstetric ultrasound for the detection of congenital heart diseases and the current unfeasibility of universal screening of congenital heart diseases through fetal echocardiography, the importance of the fetal morphological ultrasound and its performance by qualified professionals is reinforced for a more appropriate management of these pregnancies.

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Main Authors: Pinheiro,Diesa Oliveira, Varisco,Bruna Boff, Silva,Marcelo Brandão da, Duarte,Rafaela Silva, Deliberali,Graciele Dequi, Maia,Carlos Roberto, Jiménez,Mirela Foresti, Beitune,Patrícia El
Format: Digital revista
Language:English
Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 2019
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019000100011
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spelling oai:scielo:S0100-720320190001000112019-04-10Accuracy of Prenatal Diagnosis of Congenital Cardiac MalformationsPinheiro,Diesa OliveiraVarisco,Bruna BoffSilva,Marcelo Brandão daDuarte,Rafaela SilvaDeliberali,Graciele DequiMaia,Carlos RobertoJiménez,Mirela ForestiBeitune,Patrícia El fetal heart disease fetal echocardiography morphological sonography Abstract Objective To evaluate the accuracy of the diagnosis of fetal heart diseases obtained through ultrasound examinations performed during the prenatal period compared with the postnatal evaluation. Methods A retrospective cohort study with 96 pregnant women who were attended at the Echocardiography Service and whose deliveries occurred at the Complexo Hospitalar Santa Casa de Porto Alegre, in the state of Rio Grande do Sul, Brazil. Risk factor assessment plus sensitivity and specificity analysis were used, comparing the accuracy of the screening for congenital heart disease by means of obstetrical ultrasound and morphological evaluation and fetal echocardiography, considering p < 0.05 as significant. The present study was approved by the Research Ethics Committee of the Institution. Results The analysis of risk factors shows that 31.3% of the fetuses with congenital heart disease could be identified by anamnesis. The antepartum echocardiography demonstrated a sensitivity of 97.7%, a specificity of 88.9%, and accuracy of 93% in the diagnosis of congenital heart disease. A sensitivity of 29.3% was found for the obstetric ultrasound, of 54.3% for themorphological ultrasound, and of 97.7% for the fetal echocardiography. The fetal echocardiography detected fetal heart disease in 67.7% of the cases, the morphological ultrasound in 16.7%, and the obstetric ultrasound in 11.5% of the cases. Conclusion There is a high proportion of congenital heart disease in pregnancies with no risk factors for this outcome. Faced with the disappointing results of obstetric ultrasound for the detection of congenital heart diseases and the current unfeasibility of universal screening of congenital heart diseases through fetal echocardiography, the importance of the fetal morphological ultrasound and its performance by qualified professionals is reinforced for a more appropriate management of these pregnancies.info:eu-repo/semantics/openAccessFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia v.41 n.1 20192019-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019000100011en10.1055/s-0038-1676058
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country Brasil
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libraryname SciELO
language English
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author Pinheiro,Diesa Oliveira
Varisco,Bruna Boff
Silva,Marcelo Brandão da
Duarte,Rafaela Silva
Deliberali,Graciele Dequi
Maia,Carlos Roberto
Jiménez,Mirela Foresti
Beitune,Patrícia El
spellingShingle Pinheiro,Diesa Oliveira
Varisco,Bruna Boff
Silva,Marcelo Brandão da
Duarte,Rafaela Silva
Deliberali,Graciele Dequi
Maia,Carlos Roberto
Jiménez,Mirela Foresti
Beitune,Patrícia El
Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations
author_facet Pinheiro,Diesa Oliveira
Varisco,Bruna Boff
Silva,Marcelo Brandão da
Duarte,Rafaela Silva
Deliberali,Graciele Dequi
Maia,Carlos Roberto
Jiménez,Mirela Foresti
Beitune,Patrícia El
author_sort Pinheiro,Diesa Oliveira
title Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations
title_short Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations
title_full Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations
title_fullStr Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations
title_full_unstemmed Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations
title_sort accuracy of prenatal diagnosis of congenital cardiac malformations
description Abstract Objective To evaluate the accuracy of the diagnosis of fetal heart diseases obtained through ultrasound examinations performed during the prenatal period compared with the postnatal evaluation. Methods A retrospective cohort study with 96 pregnant women who were attended at the Echocardiography Service and whose deliveries occurred at the Complexo Hospitalar Santa Casa de Porto Alegre, in the state of Rio Grande do Sul, Brazil. Risk factor assessment plus sensitivity and specificity analysis were used, comparing the accuracy of the screening for congenital heart disease by means of obstetrical ultrasound and morphological evaluation and fetal echocardiography, considering p < 0.05 as significant. The present study was approved by the Research Ethics Committee of the Institution. Results The analysis of risk factors shows that 31.3% of the fetuses with congenital heart disease could be identified by anamnesis. The antepartum echocardiography demonstrated a sensitivity of 97.7%, a specificity of 88.9%, and accuracy of 93% in the diagnosis of congenital heart disease. A sensitivity of 29.3% was found for the obstetric ultrasound, of 54.3% for themorphological ultrasound, and of 97.7% for the fetal echocardiography. The fetal echocardiography detected fetal heart disease in 67.7% of the cases, the morphological ultrasound in 16.7%, and the obstetric ultrasound in 11.5% of the cases. Conclusion There is a high proportion of congenital heart disease in pregnancies with no risk factors for this outcome. Faced with the disappointing results of obstetric ultrasound for the detection of congenital heart diseases and the current unfeasibility of universal screening of congenital heart diseases through fetal echocardiography, the importance of the fetal morphological ultrasound and its performance by qualified professionals is reinforced for a more appropriate management of these pregnancies.
publisher Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publishDate 2019
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019000100011
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