EP04.02: Clinical application of CASSEAL (fetal cardiovascular system sonographic evaluation algorithm) for the diagnosis of fetal cardiovascular anomalies

Abstract

To evaluate the diagnostic capability of CASSEAL in the ultrasound detection of congenital cardiovascular anomalies in the second trimester of pregnancy. CASSEAL is an algorithm for exploring the fetal super extended cardiovascular system and it is based on the acquisition of 9 different axial views, from the umbilical vein to the subclavian arteries. CASSEAL was applied in a cross-sectional study on singleton/multiple gestations from 19–22 weeks attending our unit for routine US examination along a 6 months period. When a fetal cardiovascular anomaly was detected, the affected views were registered. Pathological cases were followed-up until birth to confirm the findings. Sensitivity and specificity of CASSEAL were estimated. A total of 174 women and 198 fetuses were assessed using CASSEAL. Mean gestational age was 20 (±0.6) weeks. In 9 (4.5%) cases a cardiovascular anomaly was found, with 2 cases (1%) showing mayor defects (table 1). All cases were confirmed after birth and there was 1 false negative case detected at 35 weeks of gestation. Sensitivity and specificity were 90% and 100%, respectively. CASSEAL may be a useful algorithm for the prenatal diagnosis of fetal cardiovascular anomalies. It allows detection of mayor anomalies as well as minor anomalies or anatomical variants which could be associated to cardiac defects and syndromes.