Factors controlling fetal echocardiography determine the diagnostic accuracy of isolated ventricular septal defect

Fetal echocardiography (FECG) is a key screening tool for prenatal cardiac abnormalities. Herein, we examined the ultrasonic factors determining prenatal ultrasonic diagnosis of isolated ventricular septal defect (IVSD).

The diagnostic role of ultrasonic factors was investigated in patients in middle or late pregnancy, diagnosed with IVSD by FECG and confirmed using postnatal echocardiography.

One hundred and six patients with IVSD were enrolled; the majority had perimembranous VSD. The combined imaging mode of 2 dimentional-echocardiography (2DE) and color doppler flow imaging (CDFI) showed the highest rate (56.6%) of IVSD detection, while CDFIwas more efficient than 2DE (32.1% vs. 11.3%). The single-view mode was more efficient than multiple-view mode (75.5% vs. 24.5%). The highest efficient mode to detect IVSD was achieved using combined imaging mode on the single view of the left ventricular outflow tract view (LVOTV) (28.3%). FECG correctly classified 71.7% of fetal IVSD. There was a significant difference of accuracy rate in classifying IVSD among the three different imaging modes (χ ²=7.141, P<0.05). The single imaging mode of CDFIand the mode of CDFIcombined with 2DE correctly classified 75.9% and 75.0% of fetal IVSD, respectively. LVOTV was the most accurate view of fetal IVSD classification (85.2%; χ ²=15.782, P<0.05). There was no difference in accuracies of IVSD classification among multiple-view modes (χ ²=2.343, P>0.05) or between single-view mode and multiple-view mode (χ ²=0.32, P>0.05).

Single LVOTV in CDFIor CDFIcombined with 2DE of FECG were the most effective diagnostic modes for fetal IVSD diagnosis.