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Espinoza J, Lee W, Viñals F, Martinez JM, Bennasar M, Rizzo G, Belfort M. Collaborative study of 4-dimensional fetal echocardiography in the first trimester of pregnancy. JOURNAL OF ULTRASOUND IN MEDICINE 2014; 33:1079-84. [PMID: 24866615 DOI: 10.7863/ultra.33.6.1079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Accumulating evidence supports a role for 2-dimensional fetal echocardiography in the first trimester of pregnancy for the identification of congenital heart defects. Our objective was to investigate the role of 4-dimensional (4D) sonography in the identification of congenital heart defects between 11 and 15 weeks of pregnancy. METHODS This study included 4 centers with expertise in first-trimester 4D fetal echocardiography. Fetuses with and without confirmed heart defects were evaluated between 11 and 15 weeks and their volume data sets were uploaded onto a centralized file transfer protocol server. RESULTS Forty-eight volume data sets from fetuses with normal (n = 17) and abnormal (n = 16) hearts were evaluated. Overall, the median (range) accuracy, sensitivity, and specificity, as well as the positive and negative likelihood ratios, for the identification of fetuses with congenital heart defects were 79% (77%-83%), 90% (70%-96%), 59% (58%-93%), 2.35 (2.05-9.80), and 0.18 (0.08-0.32), respectively. CONCLUSIONS (1) Four-dimensional fetal echocardiography can be performed in the first and early second trimesters of pregnancy; and (2) 4D volume data sets obtained from fetuses between 11 and 15 weeks can be remotely acquired and accurately interpreted by different centers.
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Affiliation(s)
- Jimmy Espinoza
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
| | - Wesley Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.)
| | - Fernando Viñals
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.)
| | - Josep Maria Martinez
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.)
| | - Mar Bennasar
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.)
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.)
| | - Michael Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.)
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