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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
1996-3-27
|
| pubmed:abstractText |
The aim of this study was to assess whether a screening program for fetal cardiac malformations is justified in a low-risk population, and which factors influence its accuracy. The fetal heart was evaluated in 7024 pregnant women at 20-22 weeks, and evaluation was repeated at a more advanced gestational age in 9% of cases. Cardiological follow-up was continued postnatally until 2 years of age. The overall prevalence of cardiac anomaly was 0.93%. The incidences of major and minor defects were 0.44% and 0.48%, respectively. There were 23 true positives (0.33%): in 20 cases, the diagnosis was made in the second trimester, and 13 women (65%) chose termination of pregnancy. Seventeen of the 20 cases identified in the second trimester were serious malformations. There were 42 false negatives (0.60%). Of these, 12 had signs of cardiac dysfunction at birth or within the 1st month of life, and three of them died as a result of their cardiac anomaly. There were eight false positives (0.11%), all of a minor type. Six abnormal karyotypes, out of a total of 21 performed in the true-positive group (28.5%), were found. In addition, five of the 42 newborns in the false-negative group had trisomy 21. The overall sensitivity was 35.4%, and 61.3% for major defects. The accuracy in two distinct periods was estimated because the level of experience of the operators was different: sensitivity was 45.2% in period 1 (1986-88) (77.8% for major defects) and 26.5% in period 2 (1989-92) (52.9% for major defects). We conclude that a fetal heart screening program in the obstetric population is justified. It defines a high-risk group for karyotyping, allows planning of delivery in a tertiary center or the choice of terminating the pregnancy for the parents and appears to have a positive cost-benefit ratio. A crucial factor is the level of training and experience of the operators, who need specific teaching support.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Nov
|
| pubmed:issn |
0960-7692
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
6
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
313-9
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:8590200-Adolescent,
pubmed-meshheading:8590200-Adult,
pubmed-meshheading:8590200-Cost-Benefit Analysis,
pubmed-meshheading:8590200-False Negative Reactions,
pubmed-meshheading:8590200-False Positive Reactions,
pubmed-meshheading:8590200-Female,
pubmed-meshheading:8590200-Fetal Heart,
pubmed-meshheading:8590200-Follow-Up Studies,
pubmed-meshheading:8590200-Heart Defects, Congenital,
pubmed-meshheading:8590200-Humans,
pubmed-meshheading:8590200-Incidence,
pubmed-meshheading:8590200-Longitudinal Studies,
pubmed-meshheading:8590200-Mass Screening,
pubmed-meshheading:8590200-Pregnancy,
pubmed-meshheading:8590200-Pregnancy Outcome,
pubmed-meshheading:8590200-Risk Factors,
pubmed-meshheading:8590200-Sensitivity and Specificity,
pubmed-meshheading:8590200-Ultrasonography, Prenatal
|
| pubmed:year |
1995
|
| pubmed:articleTitle |
Fetal heart screening in low-risk pregnancies.
|
| pubmed:affiliation |
Department of Obstetrics and Gynecology, Instituto per l'Infanzia, Trieste, Italy.
|
| pubmed:publicationType |
Journal Article
|