Title: <scp>OP12</scp>.06: Antenatal accuracy of fetal echocardiography in the diagnosis of fetal coarctation of aorta
Abstract: Coarctation of aorta (CoA) remains one of the most challenging cardiac lesions in antenatal ultrasound diagnosis. This study was performed to show antenatal accuracy of fetal echocardiography in the diagnosis of coarctation of aorta. Fetuses suspected of having CoA by antenatal echocardiography were included between 2008 and 2012 in a tertiary center. Postnatal diagnosis was confirmed by pediatric cardiologists using echocardiography with or without cardiac computerized tomography. Of the 67 fetuses suspected of having CoA by antenatal echocardiography, 56 infants were born alive, but the other 11 fetuses were lost to follow-up. In four cases, CoA was suspected in the initial scan, but follow-up scan could not show the CoA during gestation. They were excluded in final analysis. We divided antenatal CoA cases into two categories. One is expected to have good prognosis; isolated CoA with or without VSD or pesistent LSVC (Group I) and the other is to have relatively grave prognosis (Group II). Group I consisted of isolated CoA (n = 9), CoA with VSD (n = 11), and CoA with persistent LSVC (n = 1). Group II consisted of CoA combined with interrupted aortic arch (n = 2), hypoplastic left heart syndrome (n = 12) and other major intracardiac anomaly (n = 17). Incorrect diagnosis of CoA was found in 11 cases after postnatal evaluation. Two cases came from Group I and 9 cases from Group II. Overall diagnostic accuracy was 78.8% (41/52) (90.5 % (19/21) of Group I and 71.0% (22/31) of Group II) In the two false positive cases of Group I, the initial scan was performed in the late gestation (34+4 and 39+4 weeks). Serial examinations are important in the antenatal diagnosis of CoA and the diagnosis of CoA with complex intracardiac anomaly remains still challenging. In the late gestation, it is cautioned to discern the CoA because the right heart seems to be dominant in the normal fetus.