Related Experiment Video
Updated: Jun 1, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
First-trimester ductus venosus screening for cardiac defects: a meta-analysis
S I Papatheodorou1, E Evangelou, G Makrydimas
1Department of Obstetrics and Gynaecology, University of Ioannina School of Medicine, Greece.
Insights
Abnormal ductus venosus (DV) Doppler waveform shows potential for screening congenital heart disease (CHD) in chromosomally normal fetuses. Its performance varies based on nuchal translucency (NT) status, offering valuable insights for clinical use.
Area of Science:
- Perinatology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Congenital heart disease (CHD) represents the most frequent type of congenital abnormality.
- Early detection of fetal cardiac defects is crucial for improved neonatal outcomes.
Purpose of the Study:
- To conduct a meta-analysis evaluating the screening performance of abnormal ductus venosus (DV) Doppler waveform for detecting CHD in chromosomally normal fetuses.
- To assess the diagnostic accuracy of DV Doppler in different nuchal translucency (NT) categories.
Main Methods:
- A systematic literature search was performed across major databases (MEDLINE, ISI, SCOPUS, EMBASE) from 1999 to March 2011.
- Included studies focused on the first-trimester diagnostic performance of DV for CHD in chromosomally normal fetuses, irrespective of NT status.
- Hierarchical summary receiver operating characteristic (HSROC) curves were utilized for meta-analysis.
Main Results:
- Across all included fetuses (n=50,354), DV screening demonstrated a sensitivity of 50% and specificity of 93% for CHD detection.
- In fetuses with increased NT, sensitivity was 83% and specificity 80%.
- In fetuses with normal NT, sensitivity was 19% and specificity 96%.
Conclusions:
- The ductus venosus (DV) Doppler waveform assessment shows potential as a screening tool for congenital heart disease (CHD) in chromosomally normal fetuses.
- The performance characteristics of DV screening vary significantly depending on the fetal nuchal translucency (NT) status.
- These findings aid in evaluating the clinical utility and limitations of DV Doppler for prenatal CHD screening.
Background:
Heart defects are the most common congenital abnormalities.
Objective:
We aimed to evaluate in a meta-analysis the screening performance of abnormal ductus venosus (DV) Doppler waveform for detection of congenital heart disease (CHD) in chromosomally normal fetuses.
Search Strategy:
Studies were retrieved from a search of MEDLINE, ISI, SCOPUS and EMBASE (from 1999 to March 2011) using the keywords 'ductus venosus', 'DV', 'chromosomal abnormalities', 'congenital heart disease' and 'nuchal translucency'.
Selection Criteria:
We considered all studies that examined the diagnostic performance of DV in the first trimester for CHD in chromosomally normal fetuses. We included studies that were limited to fetuses with increased nuchal translucency (NT), normal NT, and studies that examined fetuses regardless of NT status.
Data Collection And Analysis:
Seven studies (n = 50,354) regardless of the NT status, nine studies (n = 2908) with increased NT and seven studies (n = 47,610) with normal NT were included in the meta-analysis. We drew hierarchical summary receiver operating characteristic (HSROC) curves using the parameters of the fitted models.
Main Results:
In populations including participants regardless of NT status, the summary sensitivity and specificity of DV for detecting CHD were 50 and 93%, respectively. In participants with increased NT, the summary sensitivity and specificity were 83 and 80%, and in those with normal NT, they were 19 and 96%, respectively.
Authors' Conclusions:
The estimated performance of DV assessment for detection of CHD in chromosomally normal fetuses can be considered in evaluating the potential use and limitations of this screening test.
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...