Key result
A restrictive appearance of the foramen ovale on fetal echocardiography strongly predicted the need for urgent balloon atrial septostomy at birth in fetuses with TGA (OR 71.1; 95% CI 8.3-608.5; p<0.0001).
Why the study?
To explore the role of fetal echocardiography in predicting the risk of urgent balloon atrial septostomy (BAS) at birth in fetuses diagnosed with transposition of the great arteries (TGA).
Can prenatal echocardiographic parameters predict the need for urgent balloon atrial septostomy at birth in fetuses with transposition of the great arteries?
Population
292 fetuses with TGA across 6 studies
Comparison
Fetuses requiring urgent BAS within 24 h of birth vs those not requiring urgent BAS
Design
Systematic review and random-effects meta-analysis
Authors
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Restrictive foramen ovale on fetal echocardiography identifies TGA fetuses at high risk for urgent BAS; supports incorporating this parameter into prenatal counseling and delivery planning.
Meta-Analysis (n=292)
Can prenatal echocardiographic parameters predict the need for urgent balloon atrial septostomy at birth in fetuses with transposition of the great arteries?
Effect estimate: OR 71.1 (95% CI 8.3-608.5)
Absolute Event Rate: 64.5% vs 7.9%
p-value: p=<.0001
Prenatal fetal echocardiography, particularly the identification of a restrictive foramen ovale, can effectively stratify the risk of needing an urgent balloon atrial septostomy at birth in fetuses with transposition of the great arteries.
Buca et al. (2020) conducted a meta-analysis in Transposition of the great arteries (TGA) (n=292). Restrictive appearance of the foramen ovale vs. Non-restrictive appearance was evaluated on Requirement of urgent balloon atrial septostomy (BAS) within 24 h of birth (OR 71.1, 95% CI 8.3-608.5, p=<.0001). A restrictive appearance of the foramen ovale on fetal echocardiography strongly predicted the need for urgent balloon atrial septostomy at birth in fetuses with TGA (OR 71.1; 95% CI 8.3-608.5; p<0.0001).
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