Prenatal detection of coarctation of the aorta in a non-selected population: A prospective analysis of 10years of experience

ObjectivesThe aim of our prospective study was to assess the ability of different parameters to identify fetuses requiring neonatal care for coarctation of the aorta (CoA).MethodsBetween January 2003 and December 2012, 175 fetuses of our region referred for great vessel disproportion (pulmonary valve/aortic valve (AoV) diameter ratio≥1.6) were divided into two groups: group A (n=51) with high risk of CoA and delivery planned in tertiary care referral center; group B (n=124) with no increased risk of CoA. Fetuses with Z-score aortic valve AoV<−2 at 36weeks of amenorrhea (WA) (measurements of AoV were normalized to femoral length with Schneider's Z-score equation) or with hypoplastic and/or angular aortic arches were considered at high risk of CoA and therefore in group A. Fetuses with at least 2 minor criteria: diagnosis before 28WA, Z-score AoV<−1.2, ventricular septal defect and bicuspid AoV were also included in group A. Persistent left superior vena cava (LSVC) was not considered high risk, but was reported. All neonates in the 2 groups had completed postnatal follow-up with echocardiography.ResultsIn group A, diagnosis of CoA was confirmed in 38/51 (75%) and isolated CoA in 22/34 (65%). In group B, 2/124 had CoA (false negative rate 1.6%). In univariate analysis, except for the LSVC, all parameters were significant (P