Key result
Prenatal ultrasound parameters including coarctation shelf strongly predict true CoA in suspected fetuses.
Why the study?
The study was conducted to investigate the incidence and significant ultrasound parameter changes of coarctation of the aorta among fetuses with suspected coarctation of the aorta.
Do specific prenatal ultrasound parameters predict the true presence of coarctation of the aorta in fetuses suspected of the condition?
Observational (n=133)
No
Do specific prenatal ultrasound parameters predict the true presence of coarctation of the aorta in fetuses suspected of the condition?
Effect estimate: OR 17.71 (95% CI 5.52-56.78)
p-value: p=<0.05
Sagittal view isthmus Z-score, coarctation shelf, ascending aortic diameter, and ductus arteriosus velocity time integral are independent ultrasound predictors that can help differentiate true coarctation of the aorta from false-positive cases in suspected fetuses.
To investigate the incidence and significant ultrasound parameter changes of coarctation of the aorta (CoA) among fetuses with suspected CoA, pregnant women with suspected CoA fetuses on prenatal ultrasound examination were prospectively enrolled. The CoA presence was confirmed after birth by computed tomographic angiography, ultrasound, surgery or autopsies. The ultrasound parameters were analyzed. Among 133 fetuses with suspected CoA, 44 (33.1%) pregnant women with CoA fetuses were confirmed after delivery with an age range 20-41 (31.36 ± 4.73) years and a gestational age range 20.5-36.5 (27.35 ± 4.52) weeks, and 89 (66.9%) pregnant women were confirmed to have false-positive CoA fetuses with matched (P > 0.05) age (range 21-44 and mean 30.96 ± 4.59 years) and gestational age (range 19.6-34.1 and mean 28.22 ± 3.28 weeks). Ductus arteriosus (DA) tortuosity was present in significantly (P < 0.05) more false-positive CoA fetuses (15 or 16.85%) than in true CoA fetuses (1 or 2.27%), whereas significantly more intracardiac malformation [25 (56.82%) vs. 31 (34.83%)] and ventricular septal defect [10 (22.73%) vs. 6 (6.74%)] took place in true CoA fetuses than in the counterparts. Significant (P < 0.05) independent risk factors for CoA presence were sagittal view isthmic Z-score (odds ratio or OR 3.62 and 95% confidence interval or CI 2.06-7.15), coarctation shelf (OR 17.71 and 95% CI 5.52-56.78), ascending aortic diameter (OR 109.67 and 95% CI 3.03-21068.82), and DA velocity time integral (VTI) (OR 24.98 and 95% CI 1.26-759.94). The cutoff value and AUC were 0.40 and 0.912, respectively, for the fitted model, -4.24 and 0.779 for isthmus Z-score, 0.35 and 0.685 for the ascending aorta diameter, and 13.78 and 0.623 for DA VTI. In conclusion, many ultrasound parameters are significantly different in CoA fetuses, and sagittal view isthmus Z-score, coarctation shelf, ascending aortic diameter, DA VTI may independently affect CoA presence.
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Chen et al. (2025) conducted an observational in Suspected coarctation of the aorta in fetuses (n=133). Prenatal ultrasound parameters (coarctation shelf) vs. False-positive CoA fetuses was evaluated on Presence of true coarctation of the aorta (OR 17.71, 95% CI 5.52-56.78, p=<0.05). Prenatal ultrasound parameters including coarctation shelf (OR 17.71), ascending aortic diameter (OR 109.67), sagittal view isthmic Z-score (OR 3.62), and ductus arteriosus VTI (OR 24.98) independently predicted true coarctation of the aorta in suspected fetuses.
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