First-trimester ultrasound examination for detecting major congenital heart disease

A positive first-trimester ultrasound scan appears to be accurate in ruling in the diagnosis of major congenital heart disease but evidence of a negative scan in ruling out the diagnosis is inconclusive.

A systematic review including 10 studies with a total of 1 243 pregnant women was abstracted in DARE. Of the studies, 4 used transabdominal ultrasonography, 4 used transvaginal and 2 used a combination to detect congenital heart diseases during the first trimester. Eight studies assessed a high-risk population. Only 4 studies used an appropriate reference standard (postnatal or postmortem assessment). Pooled sensitivity and specificity were 85% (95% CI 78-90%) and 99% (95% CI, 98-100%), respectively. Sensitivity ranged in transabdominal ultrasound studies from 25% to 100%, in transvaginal ultrasound studies from 33 to 86% and in combination studies from 78 to 89%. Specifity was high in all studies ranging from 96% to 100%. The findings of high-quality studies were consistent with the overall results.

Comment: The quality of evidence is downgraded by study quality (lack of blinding and lack of an appropriate reference standard).

Ədəbiyyat

1. Rasiah SV, Publicover M, Ewer AK, Khan KS, Kilby MD, Zamora J. A systematic review of the accuracy of first-trimester ultrasound examination for detecting major congenital heart disease. Ultrasound Obstet Gynecol. 2006;28(1):110-6.