EP04.44: Accuracy of early fetal echocardiography within 16 weeks of gestation in the diagnosis of aortic arch anomalies in a high‐risk population

Abstract

The aim of the study was to evaluate the feasibility of making a correct prenatal diagnosis of aortic arch anomalies with early fetal echocardiography in an high-risk population. Early fetal echocardiography was performed in high-risk pregnancies (NT > 99th percentile, NT between 95th and 99th percentile with tricuspid regurgitation (TR) or abnormal flow of the ductus venosus (DV), TR and abnormal DV, previous child affected by congenital heart disease (CHD), suspected CHD or extra-cardiac anomaly during early fetal anomaly scan). In all cases a fetal echocardiographic evaluation was offered at 19-21, 32-34 weeks of gestation and postnatally. On early fetal echocardiography we identified 29 cases of aortic arch anomalies. Fifteen cases were excluded from the study because parents opted for termination of pregnancy in the first trimester. In the 14 remaining cases, we diagnosed 6 cases of coarctation of the aorta (CoA) and 8 right aortic arch (RAA); in 5/6 cases the CoA was severe. In all but one cases the diagnosis was confirmed at the follow up scan: only in 1 case the diagnosis of RAA was slightly modified into double aortic arch (DAA). In addition we had 3 false negative cases (2 CoA, 1 RAA). Our study confirmed the feasibility of making a correct prenatal diagnosis of aortic arch anomalies based on early fetal echocardiography.