First-trimester measurement of the ductus venosus pulsatility index and the prediction of congenital heart defects

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective This study was carried out to evaluate the additional predictive value of ductus venosus pulsatility index for veins (DV-PIV) in the identification of congenital heart defects (CHDs) in fetuses with an enlarged nuchal translucency (NT) and a normal karyotype. Methods All chromosomally normal fetuses referred to our Fetal Medicine Unit between September 1996 and December 2008 with known NT, DV-PIV and ductus venosus (DV) a-wave measurements were included. Intrafetus variation in DV-PIV was overcome by averaging three recordings. Follow-up included special focus on CHD. The odds of CHD at any NT and DV-PIV value were evaluated using logistic regression analysis. Results Of 792 fetuses included, the NT was enlarged (equal to or above the 95th percentile (P95)) in 318 (40.2%). The DV-PIV was abnormal (≥ P95) in 41.8% of the fetuses with an enlarged NT and the a-wave was abnormal (negative or reversed) in 29.9%. CHD was diagnosed in 35 fetuses, 33 of which had an enlarged NT. Amongst the fetuses with an enlarged NT, the sensitivities for CHD of abnormal DV-PIV and DV a-wave were 73% and 55%, with specificities of 62% and 73%, respectively. Logistic regression analysis showed that in this risk group the DV-PIV multiple of the median (MoM) (as a continuous variable) was significantly associated with the risk of CHD (odds ratio = 2.4), independent of the degree of NT enlargement, whereas the DV a-wave did not significantly add to the prediction of CHD. Conclusion Two-thirds of fetuses with an enlarged NT, a normal karyotype and CHD have an increased DV-PIV. DV-PIV can be used as continuous variable in combination with NT to increase specificity in the identification of CHD and to refine the individual risk assessment. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Original languageEnglish
Pages (from-to)668-675
JournalUltrasound in Obstetrics and Gynecology
Volume36
Issue number6
DOIs
Publication statusPublished - 2010
Externally publishedYes

Cite this

@article{7f2c41f248b747a6b895c6b86fbe0f08,
title = "First-trimester measurement of the ductus venosus pulsatility index and the prediction of congenital heart defects",
abstract = "Objective This study was carried out to evaluate the additional predictive value of ductus venosus pulsatility index for veins (DV-PIV) in the identification of congenital heart defects (CHDs) in fetuses with an enlarged nuchal translucency (NT) and a normal karyotype. Methods All chromosomally normal fetuses referred to our Fetal Medicine Unit between September 1996 and December 2008 with known NT, DV-PIV and ductus venosus (DV) a-wave measurements were included. Intrafetus variation in DV-PIV was overcome by averaging three recordings. Follow-up included special focus on CHD. The odds of CHD at any NT and DV-PIV value were evaluated using logistic regression analysis. Results Of 792 fetuses included, the NT was enlarged (equal to or above the 95th percentile (P95)) in 318 (40.2{\%}). The DV-PIV was abnormal (≥ P95) in 41.8{\%} of the fetuses with an enlarged NT and the a-wave was abnormal (negative or reversed) in 29.9{\%}. CHD was diagnosed in 35 fetuses, 33 of which had an enlarged NT. Amongst the fetuses with an enlarged NT, the sensitivities for CHD of abnormal DV-PIV and DV a-wave were 73{\%} and 55{\%}, with specificities of 62{\%} and 73{\%}, respectively. Logistic regression analysis showed that in this risk group the DV-PIV multiple of the median (MoM) (as a continuous variable) was significantly associated with the risk of CHD (odds ratio = 2.4), independent of the degree of NT enlargement, whereas the DV a-wave did not significantly add to the prediction of CHD. Conclusion Two-thirds of fetuses with an enlarged NT, a normal karyotype and CHD have an increased DV-PIV. DV-PIV can be used as continuous variable in combination with NT to increase specificity in the identification of CHD and to refine the individual risk assessment. Copyright {\circledC} 2010 ISUOG. Published by John Wiley & Sons, Ltd.",
author = "E. Timmerman and Clur, {S. A.} and E. Pajkrt and Bilardo, {C. M.}",
year = "2010",
doi = "10.1002/uog.7742",
language = "English",
volume = "36",
pages = "668--675",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

First-trimester measurement of the ductus venosus pulsatility index and the prediction of congenital heart defects. / Timmerman, E.; Clur, S. A.; Pajkrt, E.; Bilardo, C. M.

In: Ultrasound in Obstetrics and Gynecology, Vol. 36, No. 6, 2010, p. 668-675.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - First-trimester measurement of the ductus venosus pulsatility index and the prediction of congenital heart defects

AU - Timmerman, E.

AU - Clur, S. A.

AU - Pajkrt, E.

AU - Bilardo, C. M.

PY - 2010

Y1 - 2010

N2 - Objective This study was carried out to evaluate the additional predictive value of ductus venosus pulsatility index for veins (DV-PIV) in the identification of congenital heart defects (CHDs) in fetuses with an enlarged nuchal translucency (NT) and a normal karyotype. Methods All chromosomally normal fetuses referred to our Fetal Medicine Unit between September 1996 and December 2008 with known NT, DV-PIV and ductus venosus (DV) a-wave measurements were included. Intrafetus variation in DV-PIV was overcome by averaging three recordings. Follow-up included special focus on CHD. The odds of CHD at any NT and DV-PIV value were evaluated using logistic regression analysis. Results Of 792 fetuses included, the NT was enlarged (equal to or above the 95th percentile (P95)) in 318 (40.2%). The DV-PIV was abnormal (≥ P95) in 41.8% of the fetuses with an enlarged NT and the a-wave was abnormal (negative or reversed) in 29.9%. CHD was diagnosed in 35 fetuses, 33 of which had an enlarged NT. Amongst the fetuses with an enlarged NT, the sensitivities for CHD of abnormal DV-PIV and DV a-wave were 73% and 55%, with specificities of 62% and 73%, respectively. Logistic regression analysis showed that in this risk group the DV-PIV multiple of the median (MoM) (as a continuous variable) was significantly associated with the risk of CHD (odds ratio = 2.4), independent of the degree of NT enlargement, whereas the DV a-wave did not significantly add to the prediction of CHD. Conclusion Two-thirds of fetuses with an enlarged NT, a normal karyotype and CHD have an increased DV-PIV. DV-PIV can be used as continuous variable in combination with NT to increase specificity in the identification of CHD and to refine the individual risk assessment. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

AB - Objective This study was carried out to evaluate the additional predictive value of ductus venosus pulsatility index for veins (DV-PIV) in the identification of congenital heart defects (CHDs) in fetuses with an enlarged nuchal translucency (NT) and a normal karyotype. Methods All chromosomally normal fetuses referred to our Fetal Medicine Unit between September 1996 and December 2008 with known NT, DV-PIV and ductus venosus (DV) a-wave measurements were included. Intrafetus variation in DV-PIV was overcome by averaging three recordings. Follow-up included special focus on CHD. The odds of CHD at any NT and DV-PIV value were evaluated using logistic regression analysis. Results Of 792 fetuses included, the NT was enlarged (equal to or above the 95th percentile (P95)) in 318 (40.2%). The DV-PIV was abnormal (≥ P95) in 41.8% of the fetuses with an enlarged NT and the a-wave was abnormal (negative or reversed) in 29.9%. CHD was diagnosed in 35 fetuses, 33 of which had an enlarged NT. Amongst the fetuses with an enlarged NT, the sensitivities for CHD of abnormal DV-PIV and DV a-wave were 73% and 55%, with specificities of 62% and 73%, respectively. Logistic regression analysis showed that in this risk group the DV-PIV multiple of the median (MoM) (as a continuous variable) was significantly associated with the risk of CHD (odds ratio = 2.4), independent of the degree of NT enlargement, whereas the DV a-wave did not significantly add to the prediction of CHD. Conclusion Two-thirds of fetuses with an enlarged NT, a normal karyotype and CHD have an increased DV-PIV. DV-PIV can be used as continuous variable in combination with NT to increase specificity in the identification of CHD and to refine the individual risk assessment. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/20617506

U2 - 10.1002/uog.7742

DO - 10.1002/uog.7742

M3 - Article

VL - 36

SP - 668

EP - 675

JO - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 6

ER -