First-trimester detection of major cardiac defects with the use of biomarkers
- VernacularTitle: Жирэмсний 110-136 долоо хоногтойд биофизикийн маркеруудыг ашиглан ургийн зүрхний том гажиг хөгжлийг илрүүлэх
- Author:
Altantuya Sh
1
;
Bolormaa T
1
;
Erkhembaatar T
2
Author Information
1. National Center For Maternal And Child Health, Ulaanbaatar city, Mongolia
2. Mongolian National University of Medical Science, Ulaanbaatar city, Mongolia
- Publication Type:Journal Article
- Keywords:
Congenital heart defect;
ductusvenosus;
nuchal translucency
- From:Mongolian Medical Sciences
2017;181(3):4-9
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Congenital heart disease (CHD) is the most common congenital disorders in the newborn and about 25%
of them are complex heart diseases which needs early intervention or open heart surgery in neonate
period. The incidence of CHD is varies from 8-10 in 1000 live births and half of them are major heart
diseases. Abnormal ductusvenosus blood flow at 110-136 weeks has also been described in association
with fetal aneuploidy, cardiac defects and adverse perinatal outcome. In the last few years the clinicians
are using the nuchal translucency, ductus-venosus regurgitation in fetus as a biomarker of congenital
heart disease.
Objective:To assess the method of combining fetal nuchal translucency and ductusvenosus blood flow measurements in the detection of major cardiac defects in the first-trimester scan.
Methods:Prospective cohort study data was derived from first-trimester screening of pregnant women at National
Center for Maternal and Child Health between March 2014 and May 2017.
A total of 318 patients at 110 to 136 weeks of gestation enrolled in the study. An ultrasonography scan was performed trans abdominally (using 3 to 7.5 MHz curvilinear transducers),first, to determine gestational age from the measurement of the fetal crown-rump length; second, to measure fetal nuchal translucency thickness; and third, to assess blood flow across in the ductus-venosus.
Results:During the study period, we carried out an ultrasonographic examination at 110-136 weeks in 318 singleton
pregnancies with a live fetus and crown-rump length of 45-84 mm. The median age of women was 34
(range, 19-46 years). In our study 9(2,8%) of all singleton pregnancies were diagnosed with major heart
defects and increased NT, ductus-venosus regurgitation was shown to be strongly associated with the
CHD. The sensitivity of nuchal translucency to CHD was 83% (p-0.0001), dustus-venosus regurgitation
was 75% (p-0.007), ductus-venosus PI was 80% (p-0.001).
Conclusions:First trimester biomarkers for fetal CHD screening can detect major heart defects. Increased NT, abnormal
DV flow can be important indicators for echocardiography, which is favorablefor early prenatal diagnosis
of CHD.
- Full text:2017-181(3)-4-9.pdf
