Related Experiment Video
Updated: Jan 16, 2026
Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound 30/45MHZ System
Published on: May 5, 2018
Fetal Cardiovascular Profile Score (CVPs) in Fetal Anemia, Using Fetal Hemoglobin Bart's Disease at Mid-Pregnancy as
Panisa Hantrakun1, Kasemsri Srisupundit1,2, Theera Tongsong1,2
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Insights
Cardiovascular parameters (CVPs) effectively predict fetal Hb Bart's disease. Combining cardio-thoracic area ratio (CTAR) and hydropic sign offers the best diagnostic performance for at-risk pregnancies.
Area of Science:
- Perinatology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Fetal Hb Bart's disease poses a significant risk during pregnancy.
- Accurate and early diagnosis is crucial for effective management.
- Cardiovascular parameters (CVPs) are being investigated for their diagnostic utility.
Purpose of the Study:
- To assess the diagnostic accuracy of CVPs in identifying fetal Hb Bart's disease.
- To analyze hemodynamic changes in fetuses with anemia.
- To determine the optimal CVP components for diagnosis.
Main Methods:
- Retrospective analysis of ultrasound and fetal echocardiography data from 378 high-risk pregnancies.
- Blind assignment of five CVP components.
- Definitive diagnosis confirmed by cordocentesis or neonatal blood analysis.
Main Results:
- CVPs demonstrated high sensitivity (92.1%) and specificity (97.4%) for predicting fetal Hb Bart's disease.
- Cardio-thoracic area ratio (CTAR) alone showed strong diagnostic performance (AUC: 0.954).
- The combination of CTAR and hydropic sign assessment yielded the best diagnostic values (AUC: 0.982), comparable to full CVPs.
Conclusions:
- CVPs are highly effective in predicting fetal Hb Bart's disease in at-risk pregnancies.
- A simplified approach using CTAR and hydropic sign assessment is sufficient for optimal diagnostic performance.
- Affected fetuses exhibit compensatory hemodynamic changes to manage anemia.
Abstract:
Objectives: To evaluate the diagnostic performance of CVPs in predicting fetal Hb Bart's disease among pregnancies at risk and to study hemodynamic changes based on CVP components in response to fetal anemia. Methods: The database was assessed to retrieve the ultrasound records of fetuses at risk of Hb Bart's disease at 17-22 weeks and the relevant files including complete video sets of fetal echocardiography. The five components of CVPs of each case were blindly assigned. The definitive diagnosis of fetal Hb Bart's disease was based on cordocentesis or neonatal blood analysis. Results: Among 378 pregnancies at risk that were recruited into the study, there were 76 (20.1%) affected fetuses and 302 (79.9%) unaffected fetuses. Using a cut-off score of <9, CVPs had a sensitivity of 92.1% and specificity of 97.4% in predicting affected fetuses. However, the effectiveness was not much superior to cardio-thoracic area ratio (CTAR) alone (area under curve; AUC: 0.983 vs. 0.954). Of all parameters, CTAR provided the best diagnostic performance. The combination of CTAR and assessment of hydropic sign provided the best diagnostic values, comparable with full CVPs (AUC 0.982 vs. 0.983). The affected fetuses cope well with anemia by physically increasing in cardiac size and functionally increasing in Tei index with minimally reduced shortening fraction, without compromising arterial and venous Doppler indices. Conclusions: CVPs are highly effective in predicting affected fetuses among pregnancies at risk of fetal Hb Bart's disease. Nevertheless, only two components (CTAR and hydropic sign) are adequate to yield the best diagnostic performance.
