Open Access

REVIEW

Z-Score in Fetal Echocardiography–Is there Still Room for New Studies?

Marcio Fragoso Vieira^1,2, Nathalie Jeanne Bravo-Valenzuela³, Edward Araujo Júnior^1,*

1 Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, 04023-062, Brazil
2 Department of Obstetrics, Federal University of Ceará (UFC), Sobral-CE, 60020-181, Brazil
3 Department of Pediatrics, Pediatric Cardiology, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro-RJ, 21941-853, Brazil

* Corresponding Author: Edward Araujo Júnior. Email:

Congenital Heart Disease 2024, 19(3), 305-314. https://doi.org/10.32604/chd.2024.053484

Received 01 May 2024; Accepted 26 June 2024; Issue published 26 July 2024

Abstract

Congenital heart disease (CHD) is the most common type of birth defect, representing a significant cause of perinatal morbidity and mortality. Early diagnosis of such anomalies is crucial for improving outcomes. Current protocols recommend a qualitative assessment of cardiac structures using two-dimensional ultrasound (2DUS) and color Doppler imaging. In cases of suspected abnormalities, quantitative assessments through cardiac structure measurements and reference curves can aid in accurate diagnosis. Similar to centiles widely employed in obstetrics, Z-scores provide more precise quantification of various cardiac structures, particularly at the extremes of the curve. While the development of reference curves and Z-scores has progressed over the past two decades, a lack of standardization in measurements and statistical methodology for their determination is evident. Establishing reference curves requires adherence to specific recommendations to improve their accuracy. The purpose of this study is to provide a narrative review of the major studies that have generated reference values for cardiac structures using 2DUS and Z-scores, to evaluate their methodology, and to provide a summary of the results.

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Keywords

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