Assessment of accuracy of echocardiographic parameters in prenatal diagnostics of isolated vascular ring

  • A. Pavlova Ukrainian Children’s Cardiac Centre, Kiev
  • O. Gurjeva Ukrainian Children’s Cardiac Centre, Kiev; The National Scientific Center «M.D. Strazhesko Institute of Cardiology» of the Ukrainian National Academy of Medical Sciences
  • A. Kurkevych Ukrainian Children’s Cardiac Centre, Kiev
  • N. Rudenko Ukrainian Children’s Cardiac Centre, Kiev; Shupyk National Medical Academy of Postgraduate Education, Kiev
  • I. Yemec Ukrainian Children’s Cardiac Centre, Kiev
Keywords: vascular ring, prenatal diagnosis, echocardiography


Vascular ring (VR) is hard to diagnose prenatally and requires knowledge of anatomy of the large vessels, anatomical variants of VR and special echocardiographic views. In this study we aimed to find echocardiographic parameters which may predict diagnosis of VR. From 2011 to 2017 diagnosis of the isolated VR was established prenatally and confirmed by computer tomography after birth in 39 cases (the main group). A control group comprised 47 fetuses with normal heart anatomy. The sizes of all heart structures in both groups were evaluated according to normograms corresponding to the pregnancy term and Z-scores were calculated. Our study has shown, that in both study groups Z-score for majority of heart structures were in the normal range. Despite differences in Z-scores of mitral valve annular dimensions (MV), tricuspid valve and ductus arteriosus diameter were statistically significant, this difference was not clinically relevant and did not have predictive value for VR diagnostics. This finding was confirmed using non-parametric ROC-analyses. We may conclude that only routine use of special views is an effective method of prenatal ultrasound diagnostics of VR.


1. Comparison of cardiac Z-score with cardiac asymmetry for prenatal screening of congenital heart disease / T. Riggs, A. P. Saini, C. H. Comstock [et al.] // Ultrasound Obstet Gynecol. – 2011. – Vol. 38. – P. 332–6.

2. Development of Z-scores for fetal cardiac dimensions from echocardiography / C. Schneider, B. W. McCrindle, J. S. Carvalho [et al.] // Ultrasound Obstet Gynecol. – 2005. – Vol. 26. – P. 599–605.

3. Devore G. R. The use of Z-scores in the analysis of fetal cardiac dimensions // Ultrasound Obstet Gynecol. – 2005. – Vol. 26. – P. 596–8.

4. Effect of prenatal diagnosis on hospital costs in complete transposition of the great arteries / D. Gupta, M. E. Mowitz, D. Lopez-Colon [et al.] // Prenat Diagn. – 2018. – Vol. 19.

5. Fetuses with right aortic arch: a multicenter cohort study and meta-analysis / F. D’Antonio, A. Khalil, V. Zidere [et al.] // Ultrasound Obstet Gynecol. – 2016. – Vol. 47. – P. 423–32.

6. Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation / Hajian-Tilaki K. // Caspian J Intern Med. – 2013. – Vol. 4. – P. 627–35.

7. Predictive Models for Normal Fetal Cardiac Structures / A. Krishnan, J. I. Pike, R. McCarter [et al.] // J Am Soc Echocardiogr. – 2016. – Vol. 29. – P. 1197–1206.

8. Prenatal detection of congenital heart disease--results of a national screening programme / C. L. Van Velzen, S. A. Clur, M. E. Rijlaarsdam [et al.] // BJOG. – 2016. – Vol. 123. – P. 400–7.

9. Prenatal diagnosis and outcome of right aortic arch without significant intracardiac anomaly / Y. Razon, M. Berant, R. Fogelman [et al.] // J Am Soc Echocardiogr. – 2014. – Vol. 27. – P. 1352–8.

10. Prenatal diagnosis of vascular rings / S. Jain, B. Kleiner, A. Moon-Grady [et al.] // J Ultrasound Med. – 2010. – Vol. 29. – P. 287–94.

11. Prenatal Sonographic Features of a Double Aortic Arch: Literature Review and Perinatal Management / D. Trobo, C. Bravo, T. Alvarez [et al.] // J. Ultrasound. Med. – 2015. – Vol. 34. – P. 1921–7.

12. Systematic review and meta-analysis of the performance of second-trimester screening for prenatal detection of congenital heart defects / C. L. van Velzen, J. C .F. Ket, P. M. van de Ven [et al.] // Int J Gynaecol Obstet. – 2018. – Vol. 140. – P. 137–145.

13. The impact of prenatal diagnosis on congenital anomaly outcomes: Data from 1997 to 2016 / P. Braz, A. Machado, C. Matias Dias [et al.] // Eur J Med Genet. – 2018. – Vol. 14.
How to Cite
Pavlova, A., Gurjeva, O., Kurkevych, A., Rudenko, N., & Yemec, I. (2018). Assessment of accuracy of echocardiographic parameters in prenatal diagnostics of isolated vascular ring. Ukrainian Journal of Cardiovascular Surgery, (4 (33), 60-63.