Open Access

ARTICLE

Screening performance of congenital heart defects in first trimester using simple cardiac scan, nuchal translucency, abnormal ductus venosus blood flow and tricuspid regurgitation

Natasa Karadzov Orlic¹, Amira Egic¹, Barbara Damnjanovic‐Pazin MD2 | Relja Lukic¹, Ivana Joksic³, Zeljko Mikovic¹

1 High‐risk Pregnancy Unit, Obsterics/ Gynecolgy Clinic “Narodni font”, School of Medicine, University of Belgrade, Belgrade, Serbia
2 High‐risk Pregnancy Unit, Obsterics/ Gynecolgy Clinic “Narodni font”, Belgrade, Serbia
3 Genetic Laboratory, Obsterics/Gynecolgy Clinic “Narodni font”, University of Belgrade, Belgrade, Serbia

* Corresponding Author: Natasa Karadzov Orlic, Obsterics/Gynecolgy Clinic “Narodni font”, High‐risk Pregnancy Unit, School of Medicine, University of Belgrade, Str. Kraljice Natalije 62, Belgrade 11000, Serbia. Email:

Congenital Heart Disease 2019, 14(6), 1094-1101. https://doi.org/10.1111/chd.12852

Abstract

Objective: The objective of this study was to analyze if the addition of simple cardiac scan in cases with increased nuchal translucency (NT) and/or abnormal ductus venosus (DV) blood flow, and/or tricuspid regurgitation (TCR) can improve detection of congenital heart defects (CHD) in chromosomally normal fetuses without non‐ cardiac defects at 11‐13 + 6 gestational weeks in a population of singleton pregnancies.
Methods: During the 10 years period, all singleton pregnancies at 11‐13 + 6 weeks were routinely scanned for NT, DV blood flow and TCR assessment and, if a sin‐ gle of these parameters was abnormal, simple cardiac scan with 2D gray scale and color and/or directional power Doppler in 4‐chamber (4‐CV) and 3 vessel and trachea views (3VTV) was performed.
Results: The sensitivity and specificity of NT ≥ 95th + DV R/A a‐wave + TCR in detecting CHD were 77% and 97%, respectively, and of simple cardiac scan, 67% and 98%, respectively. Area under the curve of receiver operating characteristic curve of NT ≥ 95th + DV R/A a‐wave + TCR was 0.838, and of NT ≥ 95th + DV R/A a‐wave + TCR + simple cardiac scan was 0.915.
Conclusions: In chromosomally normal fetuses without non‐cardiac anomalies, addition of simple cardiac scan to the combined first trimester screening parameters improves detection of major CHD during first trimester.

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