Fetal echocardiography for congenital heart disease diagnosis: a meta-analysis, power analysis and missing data analysis

European Journal of Preventive Cardiology
Hong LiuXiao-Song Li

Abstract

Prenatal ultrasonography is the most widely available diagnostic test for fetal congenital heart disease (CHD), but the factors influencing its diagnostic accuracy remain uncertain despite extensive research. The aim of the present study was to evaluate the potential role of demographic, clinical and ultrasonographic characteristics on diagnostic yields for detecting CHD. A systematic search of PubMed, ISI Web of Science, SinoMed, and the Cochrane Library was performed to identify studies assessing the accuracy of prenatal ultrasound in the detection of CHD. A random effects model was used to generate pooled sensitivity and specificity in addition to summary receiver operating characteristic (SROC) curves. Overall, prenatal ultrasound in the detection of CHD had a moderate sensitivity of 68.1% (95% CI 59.6-75.5) and a favorable specificity of 99.9% (99.7-99.9). Risk level and gestation age were independent predictors of diagnostic performance for detecting CHD (p = 0.004 vs. p = 0.002, respectively). The pooled sensitivities significantly increased to varying extents with the following echocardiographic views: 48.7% (34.8-67.2) for four-chamber view (4CV); 58.0% (40.3-73.9) for a combination of 4CV and outflow tract views (OTV)...Continue Reading

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