Comparing risk factors associated with the late detection of critical congenital heart disease at different facility levels

Chiari network as a cause of neonatal hypoxemia

The Chiari network is an embryonic remnant of the right venosus, consisting of a thin, mobile structure connected to the right atrium. Neonates with the Chiari network may present with hypoxemia. We report a case of a neonate with persistent hypoxemia despite improvement in respiratory distress symptoms and increased supplemental oxygen that was diagnosed using real-time telemedicine.

Predictive Ability of Combined Factor Scores for Chromosomal Abnormalities in Pregnant Women With Polyhydramnios

AIM

This study investigated factors that can predict chromosomal abnormalities in pregnant women with polyhydramnios. The ability of prenatal factors to predict chromosomal abnormalities was evaluated using receiver operator characteristic curves.

METHODS

Of 76 eligible pregnant women, major anomalies were detected in 41 (54%) and chromosomal abnormalities in 19 (25%): trisomy 13 in one, trisomy 18 in 10, trisomy 21 in seven, and 22q11.2 deletion syndrome in one. Combined factor scores, including maternal age, major anomaly, abdominal circumference percentile, femur length percentile, and estimated fetal weight percentile, proved to be good predictors (area under the curve, 0.81-0.87) of chromosomal abnormalities and showed a sensitivity of 79% and specificity of 75%.

CONCLUSION

Combined scores demonstrated more accuracy than individual factors for predicting chromosomal abnormalities. Even if an anomaly is not detected on fetal ultrasonography, in cases with higher scores, chromosomal abnormalities should be suspected, and delivery at a level III facility may be recommended.