Value of ratio of ventricular septal defect diameter to aortic root dimension in prognosis evaluation fetal ventricular septal defect

doi:10.3877/cma.j.issn.1672-6448.2019.01.014

Chinese Journal of Medical Ultrasound (Electronic Edition) ›› 2019, Vol. 16 ›› Issue (01): 61-65. doi: 10.3877/cma.j.issn.1672-6448.2019.01.014

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• Obstetric and Gynecologic Ultrasound • Previous Articles Next Articles

Value of ratio of ventricular septal defect diameter to aortic root dimension in prognosis evaluation fetal ventricular septal defect

Kun Wang¹, Xiaohua Zhang¹, Yuanyuan Wang², Fengqun Dong¹^,^†

1. Department of Fetal Heart Ultrasonography, Hebei Maternity Hospital, Shijiazhuang 050000, China
2. Department of Ultrasound, the First Central Hospital of Baoding, Baoding 071000, China

Received:2018-10-05 Online:2019-01-01 Published:2019-01-01
Contact: Fengqun Dong

Abstract

Abstract:

Objective

To assess the value of the ratio of the ventricular septal defect diameter (D_VSD) to the aortic root dimension (D_AO) in prognosis evaluation of fetal isolated ventricular septal defects (i-VSD).

Methods

This study involved a total of 175 fetuses with i-VSD who were diagnosed by prenatal ultrasound imaging of the fetal heart and followed for 3 months after birth, including perimembranous i-VSD (n=83), muscular i-VSD (n=82), and subarterial i-VSD (n=10). Based on the ratio of D_VSD to D_AO (R=D_VSD/D_AO), VSD were divided into large (R>1/2), medium (1/3<R≤1/2), and small VSD (R≤1/3) VSD. Echocardiography follow-up was performed for 3 months after birth to observe the natural healing of i-VSD of different locations and sizes.

Results

The natural healing rates were 18.1% (15/83) and 50.0% (41/82) in fetuses with perimembranous i-VSD and muscular i-VSD during the follow-up period, respectively. There was no natural healing for 10 fetuses with subarterial i-VSD. There was a statistically significant difference in the natural healing rates of VSD at different locations (χ²=24.3, P=0.000). Of 83 fetuses with perimembranous i-VSD, 5 had small, 35 had medium, and 43 had large i-VSD, whose natural healing rates were 40.0% (2/5), 28.6% (10/35), and 7.0% (3/43) during the follow-up period, respectively. There was a statistically significant difference in the natural healing rates of perimembranous i-VSD with different R values (χ²=7.80, P=0.020). Of 82 fetuses with muscular i-VSD, 21 had small, 39 had medium, and 22 had large i-VSD, whose natural healing rates were 66.7% (14/21), 53.8% (21/39), and 27.4% (6/22), respectively. There was a statistically significant difference in the natural healing rates of muscular i-VSD with different R values (χ²=7.71, P=0.029). Of 10 fetuses with subarterial i-VSD, 2 had small, 4 had medium, and 4 had large i-VSD, and no natural healing was observed.

Conclusions

There is a difference in the natural healing rate of i-VSD at different locations. The ratio of D_VSD to D_AO (R) is of significance in the prognosis evaluation of fetuses with i-VSD.

Kun Wang, Xiaohua Zhang, Yuanyuan Wang, Fengqun Dong. Value of ratio of ventricular septal defect diameter to aortic root dimension in prognosis evaluation fetal ventricular septal defect[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(01): 61-65.

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Figures/Tables 3

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