Transposition of the great arteries: factors influencing prenatal diagnosis.

Authors :: Bertagna F
Rakza T
Vaksmann G
Ramdane-Sebbane N
Devisme L
Storme L
Francart C
Vaast P
Houfflin-Debarge V
Source :: Prenatal diagnosis [Prenat Diagn] 2014 Jun; Vol. 34 (6), pp. 534-7. Date of Electronic Publication: 2014 Mar 03.
Publication Year :: 2014
Abstract: Objective: The objective of this study is to highlight the factors that may affect prenatal diagnosis of transposition of the great arteries (TGA) in order to improve it.<br />Methods: This is a retrospective study performed between 2004 and 2009 in the maternity units from North of France. We identified a total of 68 cases of TGA (isolated or associated with only VSD or coarctation of aorta), of which 32 (47.1%) had prenatal diagnosis (PND+) and 36 did not (PND-). Maternal characteristics and ultrasound factors were studied in relation to PND.<br />Results: Maternal weight and body mass index were significantly higher in the PND- group (70.4 kg and 26.5 kg/m(2) vs 63.6 kg and 23.6 kg/m(2) , respectively). Maternal obesity (body mass index >30) was significantly more frequent in the PND- group (27.8% vs 12.5%). More than a quarter of TGA (28.1%) were diagnosed during the third trimester.<br />Conclusion: Obesity is the main cause of missed PND of TGA. Obese patients with suboptimal prenatal scans may benefit from reassessment of fetal cardiac anatomy and/or from referral for fetal echocardiography.<br /> (© 2014 John Wiley & Sons, Ltd.)