Transposition of the great arteries: factors influencing prenatal diagnosis

Prenat Diagn. 2014 Jun;34(6):534-7. doi: 10.1002/pd.4343. Epub 2014 Mar 3.

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.

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.

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.

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.

MeSH terms

  • Adult
  • Body Mass Index
  • Echocardiography / statistics & numerical data
  • Female
  • Fetal Heart / diagnostic imaging
  • France / epidemiology
  • Humans
  • Middle Aged
  • Obesity / diagnostic imaging
  • Obesity / epidemiology
  • Pregnancy
  • Pregnancy Complications / diagnostic imaging
  • Pregnancy Complications / epidemiology
  • Retrospective Studies
  • Transposition of Great Vessels / diagnostic imaging*
  • Transposition of Great Vessels / epidemiology
  • Ultrasonography, Prenatal / statistics & numerical data*
  • Young Adult