Study Reveals Key Ultrasound Parameters for Coarctation of Aorta

A recent study conducted at the Fourth Hospital of Shijiazhuang explored the incidence and significant ultrasound parameter changes of coarctation of the aorta (CoA) among fetuses with suspected CoA. The study aimed to investigate the antenatal diagnosis of CoA to facilitate immediate treatment and prevent complications post-birth. CoA is a condition characterized by aortic isthmus stenosis and accounts for a significant percentage of congenital heart diseases.

CoA can lead to severe consequences post-birth, including cardiovascular collapse due to closure of the ductus arteriosus. Antenatal confirmation of CoA is crucial for timely intervention, such as prostaglandin therapy and early surgical correction. However, the rate of accurate antenatal diagnosis of CoA remains low, with a high false-positive and false-negative rate, which can have life-threatening implications.

The study enrolled pregnant women with singleton pregnancies and conducted prenatal ultrasound examinations to assess fetuses suspected of CoA. The presence of CoA was confirmed post-birth using computed tomographic angiography, ultrasound, surgery, or autopsies. Various ultrasound parameters were analyzed, revealing significant differences between true CoA fetuses and false-positive cases.

Among the findings, the study identified specific ultrasound parameters that independently affected CoA presence, including sagittal view isthmus Z-score, coarctation shelf, ascending aortic diameter, and ductus arteriosus (DA) velocity time integral (VTI). These parameters played a significant role in distinguishing true CoA fetuses from false positives.

Additionally, the study explored factors such as the ratio of ductus arteriosus inner diameter to aortic isthmic inner diameter, decreased isthmic diameter, and aortic arch dysplasia as criteria for enrolling fetuses suspected of CoA. The presence of umbilical cord around the fetal neck (CAFN) was also assessed, with a higher incidence in false-positive CoA cases.

Overall, the study shed light on the importance of accurate antenatal diagnosis of CoA and highlighted the significance of specific ultrasound parameters in differentiating true CoA cases from false positives. By identifying key risk factors and utilizing advanced ultrasound techniques, healthcare providers can improve prenatal diagnosis accuracy and enhance patient outcomes.