000			03275na a2200277 4500
999			_c7637 _d7637
003			PC7637
005			20200320104258.0
008			130622s2013
040			_cH12O
041			_aeng
100			_aGómez Montes, Enery _9893 _eObstetricia y Ginecología
100			_aHerráiz García, Ignacio _9894 _eObstetricia y Ginecología
100			_aMendoza Soto, Alberto _9849 _ePediatría
100			_9895 _aEscribano Abad, David _eObstetricia y Ginecología
100			_aGalindo Izquierdo, Alberto _9896 _eObstetricia y Ginecología
245	0	0	_aPrediction of coarctation of the aorta in the second half of pregnancy _h[artículo]
260			_bUltrasound in Obstetrics & Gynecology, _c2013.
300			_a41(3):298-305.
500			_aFormato Vancouver: Gómez Montes E, Herraiz I, Mendoza A, Escribano D, Galindo A. Prediction of coarctation of the aorta in the second half of pregnancy. Ultrasound Obstet Gynecol. 2013;41(3):298-305.
504			_aContiene 28 referencias, 5 figuras y 3 tablas.
520			_aResumen: Objective To determine which combination of cardiac parameters provides the best prediction of postnatal coarctation of the aorta (CoAo) in fetuses with cardiac asymmetry. Methods We selected all cases of disproportion of the ventricles and great vessels prenatally diagnosed between 2003 and 2010 at the Hospital Universitario ‘12 de Octubre’, Madrid, Spain. Only appropriate-forgestational age liveborn fetuses with isolated cardiac asymmetry and with complete postnatal follow-up were included in the study. Eighty-five cases were retrieved and analyzed. Logistic regression analysis was used to select the best predictors of CoAo. Optimal cut-offs for these parameters were identified and the corresponding likelihood ratios used to calculate the post-test probability of CoAo in each fetus. Results CoAo was confirmed in 41/85 neonates (48%). The parameters selected by logistic regression and their cut-off values were: gestational age at diagnosis ≤28 weeks, Z-score of diameter of the ascending aorta≤−1.5, pulmonary valve/aortic valve diameters ratio ≥1.6 and Z-score of the aortic isthmus diameter in the three vessels and trachea view ≤−2. We divided the study group into two subgroups: Group A, in whom the diagnosis was made at ≤28 weeks’ gestation (80% CoAo (32/40)); and Group B, in whom the diagnosis was made at >28 weeks (20% CoAo (9/45)). The mean post-test probabilities of CoAo were higher in fetuses with CoAo than in normal fetuses in both subgroups (Group A, 82 vs 55%; P=0.002 and Group B, 51 vs 20%; P<0.001). In addition, a rate of growth of the aortic valve of ≤0.24 mm/week provided 80% sensitivity and 100% specificity for predicting CoAo in Group A. Conclusions We have derived a multiparametric scoring system, combining size-based cardiac parameters and gestational age at diagnosis, which may improve the accuracy of fetal echocardiography for the stratification of the risk of CoAo. The objectivity and simplicity of its components may allow its implementation in fetal cardiology units.
710			_9427 _aServicio de Obstetricia y Ginecología
710			_9446 _aServicio de Pediatría-Neonatología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc7637.pdf _ySolicitar documento
942			_2ddc _cART _n0