Diagnostic accuracy and short-term implications of prenatally diagnosed vascular rings: a single center study.

OBJECTIVE

To assess the diagnostic accuracy and postnatal outcomes of fetuses with a suspected vascular ring (VR).

STUDY

DESIGN

Single-center retrospective study of patients with suspected VR by fetal echocardiography. Postnatal evaluation included echocardiography +/- cross-sectional imaging. Outcomes, including symptomatology and surgery, were recorded and compared between VR types.

RESULTS

Of 68 suspected fetal VRs, 81% were confirmed postnatally. Concordance between fetal and postnatal anatomy was 76%. Five neonates required resuscitation unrelated to VR. Symptoms presented in 13 patients (median 45 days), independent of VR type. Surgical intervention was performed in 15 patients (median 99 days); 80% were symptomatic. At a median follow-up of 6 months, 4 patients were symptomatic including 3 postoperative.

CONCLUSIONS

Fetal echocardiography accurately identifies and characterizes VR anatomy in most instances. Specialized delivery planning in uncomplicated cases is unnecessary given absence of symptoms at birth. Fetal diagnosis may not indicate surgical disease, as symptoms do not occur in all and early surgery does not guarantee symptom resolution.