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Title: Difficult prenatal diagnosis: fetal coarctation
Authors: Buyens, A.
GYSELAERS, Wilfried 
Coumans, A.
Al Nasiry, S.
Willekes, C.
Boshoff, D.
Frijns, J.-P.
Witters, I.
Issue Date: 2012
Source: Facts, views & vision in ObGyn, 4 (4), p. 230-236
Abstract: The prenatal diagnosis of fetal coarctation is still challenging. It is mainly suspected by ventricular disproportion (smaller left ventricle than right ventricle). The sensitivity of venricular discrepancy is however moderate for the diagnosis of coarctation and there is a high false positive rate. Prenatal diagnosis of coarctation is important because the delivery can be arranged in a centre with a pediatric cardiac intensive care and this reduces postnatal complications and longterm morbidity. For many years the prenatal diagnosis of coarctation has been investigated to improve specificity and sensitivity by several of measurements. This article reviews all relevant articles from 2000 until 2011 searching pubmed and the reference list of interesting articles. An overview of specific measurements and techniques that can improve the diagnosis of coarctation has been made, such as the isthmus diameter, ductal diameter, isthmus/ductal ratio, z-scores derived from measurements of the distal aortic isthmus and arterial duct, the presence of a shelf andisthmal flow disturbance. Also 3-dimensional(3D) and 4-dimensional (4D) imaging with or without STIC has been suggested to be used as newer techniques to improve diagnosis of coarction in fetal life. Although more methods regarding prenatal diagnosis of coarctionare being investigated, he ultrasound specialist remains challenged to correctly diagnose this cardiac anomaly in prenatal life.
Keywords: prenatal diagnosis; coarctation; ventricular disproportion; isthmus/ductal ratio; discrepancy great vessels; isthmal z-scores; Doppler; flow disturbance; shelf
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ISSN: 2032-0418
Category: A1
Type: Journal Contribution
Appears in Collections:Research publications

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