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January 1, 2023Fetal Diagnosis and TherapyOpen Access

Subjective and Objective Sonographic Assessment for the Prenatal Detection of Neonatal Coarctation of the Aorta

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Key result

Antenatal ultrasound using the objective AV/PV ratio was the most promising marker for predicting postnatal coarctation of the aorta (AUC 0.81; 95% CI 0.67-0.94).

Why the study?

The study was conducted to assess the performance of antenatal ultrasound markers in detecting neonatal coarctation of the aorta.

Do objective sonographic markers improve the prenatal detection of neonatal coarctation of the aorta in fetuses with suspected CoA?

Population

83 fetuses with suspected CoA and no other cardiac abnormalities

Comparison

Neonates with confirmed CoA vs without confirmed CoA postnatally

Design

Retrospective study

Authors

ÁLÁngel LeeMonash HealthMRMaya ReddyThe Royal Melbourne HospitalMCMonica ChaiMonash Health

Discussion

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Implication

AV/PV ratio may aid fetal CoA detection; leaves open routine adoption pending prospective validation.

Study Design

Type

Observational (n=83)

Structured PICO

Do objective sonographic markers improve the prenatal detection of neonatal coarctation of the aorta in fetuses with suspected CoA?

P
Population
83 fetuses with suspected coarctation of the aorta and no other cardiac abnormalities assessed via antenatal ultrasound.
E
Exposure
Antenatal ultrasound markers including subjective assessment of ventricular and arterial asymmetry, appearance of aortic arch, presence of a persistent left superior vena cava, and objective Z-score measurements of the mitral, tricuspid, aortic (AV), and pulmonary (PV) valves
C
Comparator
Postnatal confirmation of CoA versus no CoA
O
Outcome
Performance of antenatal ultrasound markers in predicting postnatal CoAsurrogate

Main Result

Effect estimate: AUC 0.81 (95% CI 0.67-0.94)

Objective sonographic markers, particularly the aortic to pulmonary valve ratio, show promise in improving the prenatal detection of neonatal coarctation of the aorta.

Limitations

  • Confirmation in larger studies is required

Cite This Study

Lee et al. (2023) conducted an observational in Coarctation of the aorta (n=83). Antenatal ultrasound markers (AV/PV ratio) was evaluated on Prediction of postnatal CoA (AUC 0.81, 95% CI 0.67-0.94). Antenatal ultrasound using the objective AV/PV ratio was the most promising marker for predicting postnatal coarctation of the aorta (AUC 0.81; 95% CI 0.67-0.94).

synapsesocial.com/papers/6a22fdd5c650520b07cb1f89https://doi.org/10.1159/000530020
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Improved detection of coarctation of the aorta using speckle‐tracking analysis of fetal heart on last examination prior to delivery2020 · 55 citations
  2. 2Prenatal Diagnosis of Aortic Coarctation: Prediction Algorithm according to Gestational Age2021 · 7 citations
  3. 3Neonatal management of prenatally suspected coarctation of the aorta2020 · 23 citations
  4. 4How often an isolated cardiac disproportion predicts a coarctation of the aorta? Single center experience and systematic review of the literature2017 · 9 citations
  5. 5Aortic coarctation: prognostic indicators of survival in the fetus: Table 12004 · 35 citations