Utility of novel echocardiographic measurements to improve prenatal diagnosis of coarctation of the aorta

Sci Rep. 2023 Mar 25;13(1):4912. doi: 10.1038/s41598-023-31749-8.

Abstract

Prenatal recognition of coarctation of the aorta (CoA) may improve neonatal survival and reduce morbidity. However, prenatal diagnosis of CoA remains challenging, with relatively high false-positive and false-negative rates. This study aimed to identify a novel formula based on fetal echocardiographic measures to predict prenatal identification of CoA. A retrospective comparison on the echocardiographic evaluation of 30 patients with suspected CoA between May 2016 and April 2021 was performed. The patients were divided into a postnatal surgical intervention group (n = 13) and a non-intervention group (n = 17). The measurements that showed significant differences were aortic isthmus diameter Z-score (p < 0.001), ductus arteriosus diameter/aortic isthmus diameter (p < 0.001), and distal aortic arch (DA) index (p < 0.001). In the receiver operating characteristic curves analysis, the DA index was the largest with an area under the curve of 0.941 and a cutoff value of 1.28, with a sensitivity of 85% and a specificity of 94%. Measurement of the DA index improved the diagnostic rate of fetal CoA and a DA index ≧ 1.28 indicated fetal CoA cases requiring surgical intervention.

MeSH terms

  • Aorta, Thoracic / diagnostic imaging
  • Aortic Coarctation* / diagnostic imaging
  • Ductus Arteriosus* / diagnostic imaging
  • Echocardiography
  • Female
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Prenatal Diagnosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography, Prenatal