International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
Prenatal ultrasound diagnosis and prognosis of ductal-dependent congenital heart disease: A single-center study in China.
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Ouyang Yuanfu, Ling Wen, Wang Ronghua, Wu Qiumei, Lyu Guorong, Chen Fa, Weng Zongjie
Аннотация
OBJECTIVE: To investigate the prenatal ultrasound features of fetal ductal-dependent congenital heart disease (DDCHD), analyze their association with chromosomal abnormalities, and summarize clinical outcomes.
METHOD: A retrospective analysis was conducted on the clinical and ultrasound data of 308 fetuses diagnosed with DDCHD at our center over the past 10 years. The ultrasound characteristics of each DDCHD type during early pregnancy were systematically summarized. Differences in the prevalence of abnormalities and pregnancy outcomes among various DDCHD types were statistically compared.
RESULTS: In the first trimester, increased nuchal translucency showed a sensitivity of 60.7% (17/28) and specificity of 100% (28/28) for DDCHD diagnosis. Distinctive features were consistently identified in the four-chamber view and the three-vessel tracheal view. The incidence of associated abnormalities differed significantly across DDCHD types. The systemic circulation-dependent type showed the highest rate, followed by the pulmonary circulation-dependent type, whereas the transposition of the great arteries with intact ventricular septum type had the lowest. Chromosomal abnormalities were observed less often in isolated DDCHD cases (5.3%, 1/19) than in complex cases (34.1%, 14/41) ( P < 0.05). Overall live birth rate was 12.3% (38/308), with no significant differences among subtypes. However, the timing of detection had a clear impact on live birth outcomes (P < 0.001).
CONCLUSION: First-trimester ultrasound examination has diagnostic value for fetal DDCHD, identifying severe or complex cases. Second-trimester ultrasound examination plays a vital role in the accurate identification and classification of fetal DDCHD. Complex DDCHD is associated with an increased risk of chromosomal abnormalities. Early identification and classification of DDCHD are critical to improving clinical outcomes.
METHOD: A retrospective analysis was conducted on the clinical and ultrasound data of 308 fetuses diagnosed with DDCHD at our center over the past 10 years. The ultrasound characteristics of each DDCHD type during early pregnancy were systematically summarized. Differences in the prevalence of abnormalities and pregnancy outcomes among various DDCHD types were statistically compared.
RESULTS: In the first trimester, increased nuchal translucency showed a sensitivity of 60.7% (17/28) and specificity of 100% (28/28) for DDCHD diagnosis. Distinctive features were consistently identified in the four-chamber view and the three-vessel tracheal view. The incidence of associated abnormalities differed significantly across DDCHD types. The systemic circulation-dependent type showed the highest rate, followed by the pulmonary circulation-dependent type, whereas the transposition of the great arteries with intact ventricular septum type had the lowest. Chromosomal abnormalities were observed less often in isolated DDCHD cases (5.3%, 1/19) than in complex cases (34.1%, 14/41) ( P < 0.05). Overall live birth rate was 12.3% (38/308), with no significant differences among subtypes. However, the timing of detection had a clear impact on live birth outcomes (P < 0.001).
CONCLUSION: First-trimester ultrasound examination has diagnostic value for fetal DDCHD, identifying severe or complex cases. Second-trimester ultrasound examination plays a vital role in the accurate identification and classification of fetal DDCHD. Complex DDCHD is associated with an increased risk of chromosomal abnormalities. Early identification and classification of DDCHD are critical to improving clinical outcomes.