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Article: Ultrasonographic prediction of homozygous α 0-thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: Alone or in combination?

TitleUltrasonographic prediction of homozygous α 0-thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: Alone or in combination?
Authors
Keywordsα-Thalassemia
Cardiomegaly
Doppler
Middle cerebral artery
Placenta
Prenatal ultrasonography
Issue Date2010
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0960-7692/
Citation
Ultrasound In Obstetrics And Gynecology, 2010, v. 35 n. 2, p. 149-154 How to Cite?
AbstractObjective To compare the predictive values of three ultrasonographic parameters: placental thickness (PT), fetal cardiothoracic ratio (CTR) and middle cerebral artery peak systolic velocity (MCA-PSV), alone or in combination, in pregnancies affected by homozygous α 0- thalassemia at 12-20 weeks' gestation. Methods: Pregnant women at risk of carrying a fetus affected by homozygous α 0-thalassemia were studied from 1995 to 2006 using serial ultrasonography at 12-15 weeks, 16-20 weeks and 30 weeks' gestation. We measured CTR and PT from 1995, and MCAPSV as well from 1997. An invasive prenatal test was offered if cardiomegaly with or without placentomegaly was detected but the MCA-PSV results were used only retrospectively for analysis. Results: Of a total of 777 at-risk fetuses studied, 138 (17.8%) were affected by homozygous a0-thalassemia. At 12-15 weeks' gestation, 598 ultrasound examinations were performed. CTR was better than both PT and MCAPSV in the prediction of affected pregnancies. The highest sensitivity (98.3%) was achieved by the combination of CTR and/or MCA-PSV at a false-positive rate of 15.8%. At 16-20 weeks' gestation, 410 ultrasound examinations were performed, 121 of which were at the patient's first visit and 289 of which were at a follow-up visit. Both CTR and MCA-PSV predicted the affected pregnancies equally well. The sensitivity of CTR was 100.0%, but the false-positive rate was 5.2%. In contrast, the false-positive rate of MCA-PSV alone was 1.4% and that of the combination of CTR and MCA-PSV was 0%, although their sensitivities were less than 65%. Conclusions: The data suggest that adding MCA-PSV to CTR in the prediction of homozygous α 0- thalassemia can increase the sensitivity at 12-15 weeks and decrease the false-positive rate at 16-20 weeks' gestation. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/142062
ISSN
2023 Impact Factor: 6.1
2023 SCImago Journal Rankings: 2.207
ISI Accession Number ID
Funding AgencyGrant Number
Chui Fook Chuen Foundation
Funding Information:

Vivian Chan is supported by the Chui Fook Chuen Foundation.

References

 

DC FieldValueLanguage
dc.contributor.authorLeung, KYen_HK
dc.contributor.authorCheong, KBen_HK
dc.contributor.authorLee, CPen_HK
dc.contributor.authorChan, Ven_HK
dc.contributor.authorLam, YHen_HK
dc.contributor.authorTang, Men_HK
dc.date.accessioned2011-10-19T03:59:29Z-
dc.date.available2011-10-19T03:59:29Z-
dc.date.issued2010en_HK
dc.identifier.citationUltrasound In Obstetrics And Gynecology, 2010, v. 35 n. 2, p. 149-154en_HK
dc.identifier.issn0960-7692en_HK
dc.identifier.urihttp://hdl.handle.net/10722/142062-
dc.description.abstractObjective To compare the predictive values of three ultrasonographic parameters: placental thickness (PT), fetal cardiothoracic ratio (CTR) and middle cerebral artery peak systolic velocity (MCA-PSV), alone or in combination, in pregnancies affected by homozygous α 0- thalassemia at 12-20 weeks' gestation. Methods: Pregnant women at risk of carrying a fetus affected by homozygous α 0-thalassemia were studied from 1995 to 2006 using serial ultrasonography at 12-15 weeks, 16-20 weeks and 30 weeks' gestation. We measured CTR and PT from 1995, and MCAPSV as well from 1997. An invasive prenatal test was offered if cardiomegaly with or without placentomegaly was detected but the MCA-PSV results were used only retrospectively for analysis. Results: Of a total of 777 at-risk fetuses studied, 138 (17.8%) were affected by homozygous a0-thalassemia. At 12-15 weeks' gestation, 598 ultrasound examinations were performed. CTR was better than both PT and MCAPSV in the prediction of affected pregnancies. The highest sensitivity (98.3%) was achieved by the combination of CTR and/or MCA-PSV at a false-positive rate of 15.8%. At 16-20 weeks' gestation, 410 ultrasound examinations were performed, 121 of which were at the patient's first visit and 289 of which were at a follow-up visit. Both CTR and MCA-PSV predicted the affected pregnancies equally well. The sensitivity of CTR was 100.0%, but the false-positive rate was 5.2%. In contrast, the false-positive rate of MCA-PSV alone was 1.4% and that of the combination of CTR and MCA-PSV was 0%, although their sensitivities were less than 65%. Conclusions: The data suggest that adding MCA-PSV to CTR in the prediction of homozygous α 0- thalassemia can increase the sensitivity at 12-15 weeks and decrease the false-positive rate at 16-20 weeks' gestation. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.en_HK
dc.languageeng-
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0960-7692/en_HK
dc.relation.ispartofUltrasound in Obstetrics and Gynecologyen_HK
dc.rightsUltrasound in Obstetrics and Gynecology. Copyright © John Wiley & Sons Ltd.-
dc.subjectα-Thalassemiaen_HK
dc.subjectCardiomegalyen_HK
dc.subjectDoppleren_HK
dc.subjectMiddle cerebral arteryen_HK
dc.subjectPlacentaen_HK
dc.subjectPrenatal ultrasonographyen_HK
dc.subject.meshAorta, Thoracic - physiopathology - ultrasonography-
dc.subject.meshCardiomegaly - ultrasonography-
dc.subject.meshMiddle Cerebral Artery - physiopathology - ultrasonography-
dc.subject.meshPlacenta - physiopathology - ultrasonography-
dc.subject.meshalpha-Thalassemia - genetics - physiopathology - ultrasonography-
dc.titleUltrasonographic prediction of homozygous α 0-thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: Alone or in combination?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0960-7692&volume=35&issue=2&spage=149&epage=154&date=2010&atitle=Ultrasonographic+prediction+of+homozygous+alpha0-thalassemia+using+placental+thickness,+fetal+cardiothoracic+ratio+and+middle+cerebral+artery+Doppler:+alone+or+in+combination?-
dc.identifier.emailChan, V: vnychana@hkucc.hku.hken_HK
dc.identifier.emailTang, M: mhytang@hkucc.hku.hken_HK
dc.identifier.authorityChan, V=rp00320en_HK
dc.identifier.authorityTang, M=rp01701en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/uog.7443en_HK
dc.identifier.pmid20047196-
dc.identifier.scopuseid_2-s2.0-76249125841en_HK
dc.identifier.hkuros175165-
dc.identifier.hkuros180844-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-76249125841&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume35en_HK
dc.identifier.issue2en_HK
dc.identifier.spage149en_HK
dc.identifier.epage154en_HK
dc.identifier.isiWOS:000274944500004-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLeung, KY=8247106900en_HK
dc.identifier.scopusauthoridCheong, KB=26321364700en_HK
dc.identifier.scopusauthoridLee, CP=7410149538en_HK
dc.identifier.scopusauthoridChan, V=7202654865en_HK
dc.identifier.scopusauthoridLam, YH=7202563903en_HK
dc.identifier.scopusauthoridTang, M=8943401300en_HK
dc.identifier.citeulike6798271-
dc.identifier.issnl0960-7692-

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