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Using ultrasonic measurement of cardiac size in predicting congenital heart defect
1Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taiwan, Republic of China.
Insights
The RV/LV ratio in fetal hearts is a reliable indicator for detecting congenital cardiac defects. This simple measurement aids in early prenatal screening for heart anomalies.
Area of Science:
- Prenatal Diagnosis
- Fetal Cardiology
- Medical Imaging
Background:
- Congenital cardiac defects are a significant concern in prenatal diagnostics.
- Accurate and efficient screening methods are crucial for early detection.
- Standardized measurements of fetal cardiac structures are needed for reliable assessment.
Purpose of the Study:
- To evaluate the utility of fetal heart measurements, particularly the right ventricle/left ventricle (RV/LV) ratio, in screening for congenital cardiac defects.
- To establish regression equations correlating fetal heart dimensions with gestational age.
- To determine the sensitivity of different cardiac parameters in predicting fetal cardiac anomalies.
Main Methods:
- Utilized Duplex Color Doppler with real-time imaging and Doppler sector scanner.
- Studied 323 normal fetuses (17-41 weeks gestational age) and 10 abnormal cases.
- Measured five variables: right ventricle width, left ventricle width, RV/LV ratio, heart length, and cardiac volume from the four-chamber view.
Main Results:
- The RV/LV ratio remained relatively constant across gestational ages (17-41 weeks).
- The RV/LV ratio demonstrated the highest sensitivity (70%) in identifying fetal cardiac anomalies among the measured parameters.
- Left ventricle width showed a sensitivity of 40% in predicting fetal cardiac defects.
Conclusions:
- The RV/LV ratio from the four-chamber view is a simple and time-efficient screening parameter for antenatal detection of congenital cardiac defects.
- This ratio offers a valuable tool for early identification of potential fetal heart abnormalities.
- The study provides a basis for incorporating RV/LV ratio assessment into routine prenatal screenings.
Abstract:
A Duplex Color apparatus equipped with real-time imaging and Doppler sector scanner was used to scan fetal hearts, ranging from 17 to 41 weeks gestational age. A total of 323 normal fetuses were studied. The four-chamber view was obtained in a horizontal section just above the level of the fetal diaphragm. Five variables of the Chinese fetal heart in relation to the width of the right ventricle, width of the left ventricle, ratio of right ventricle/left ventricle (RV/LV), length of the fetal heart and the cardiac volume of a four-chamber view were set against gestational age in weeks and expressed in regression equations. The ratio of RV/LV is quite constant in relation to the gestational age. The mean ranges between 0.9916 for 17 weeks gestation and 1.0045 for a term fetus. In 10 abnormal cases with congenital cardiac defects, using the 5th and the 95th percentiles of this normal data as cutoff points, the RV/LV ratio had the highest sensitivity rate of 70% (7/10) in predicting fetal cardiac anomaly. The width of the left ventricle was the second most sensitive parameter with a sensitivity of 4/10 (40%). The RV/LV ratio of a four-chamber view is a simple, time-saving screening parameter for predicting congenital cardiac defects antenatally.