Universität zu Köln

Wagner, P., Eberle, K., Sonek, J., Berg, C., Gembruch, U., Hoopmann, M., Prodan, N. and Kagan, K. O. (2019). First-trimester ductus venosus velocity ratio as a marker of major cardiac defects. Ultrasound Obstet. Gynecol., 53 (5). S. 663 - 669. HOBOKEN: WILEY. ISSN 1469-0705

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Abstract

Objectives To examine ductus venosus (DV) flow in fetuses with and those without a cardiac defect and to evaluate different phases of DV flow in addition to the standard assessment of DV pulsatility index for veins (PIV) and the a-wave. Methods This was a retrospective study of singleton pregnancies that underwent first-trimester ultrasound screening, which included DV flow assessment, at the University of Tubingen (between 2010 and 2017) or the University of Cologne (between 2013 and 2016). The study population comprised normal fetuses and fetuses with major cardiac defects at a ratio of 10: 1. For each fetus, the following parameters of the DV waveform were evaluated: qualitative assessment of the a-wave, PIV measurement and ratios of flow velocities during the S-wave (S) or D-wave (D) and the a-wave (a) or v-wave (v). Reproducibility of DV-PIV and DV flow ratios was evaluated in 30 fetuses in which the DV flow was assessed twice. Results Our study population included 480 anatomically normal fetuses and 48 with a cardiac defect. Median fetal nuchal translucency (NT) in the normal and in the affected group was 1.9mm and 2.6 mm, respectively. In five (1.0%) of the normal and 18 (37.5%) of the affected cases, fetal NT thickness was above the 99th centile. In the normal group, the DV a-wave was reversed in 15 (3.1%) cases and the DV-PIV was above the 95th centile in 25 (5.2%). In the cases with cardiac defects, the a-wave was reversed and the DV-PIVmeasurement was above the 95th centile in 26 (54.2%). The reproducibility ofmeasurement of the ratios of DV flow velocities was similar to that of the DV-PIV. Most cardiac defects were associated with an abnormal a/S or a/D ratio. If the cut-off for these two ratios was set at the 5th centile of the normal distribution, the detection rate of fetal cardiac anomalies would be 62.5%. This compares favorably with the DV-PIV, which detects 26 (54.2%) of the affected fetuses for the same threshold. Conclusion In the first trimester, the a/S ratio has the potential to detect approximately 60% of congenital cardiac defects for a false-positive rate of 5%. Copyright (c) 2018 ISUOG. Published by John Wiley & Sons Ltd.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wagner, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eberle, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sonek, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berg, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gembruch, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoopmann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prodan, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kagan, K. O. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-149741
DOI:	10.1002/uog.20099
Journal or Publication Title:	Ultrasound Obstet. Gynecol.
Volume:	53
Number:	5
Page Range:	S. 663 - 669
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1469-0705
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NUCHAL TRANSLUCENCY; PULSATILITY INDEX; VENOUS DOPPLER; MIXTURE MODEL; FLOW; MALFORMATIONS; ABNORMALITIES; DIAGNOSIS Multiple languages Acoustics; Obstetrics & Gynecology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14974