Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis

© Georg Thieme Verlag KG Stuttgart.New York. Objective To determine the timeline of the first appearance of an increased CT ratio of fetuses with hemoglobin (Hb) Bart's disease. Materials and Methods A prospective longitudinal study was conducted on pregnancies at risk for fetal Hb Bart's...

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Main Authors: Chanane Wanapirak, Supatra Sirichotiyakul, Suchaya Luewan, Kasemsri Srisupundit, Fuanglada Tongprasert, Theera Tongsong
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/47044
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-470442018-04-25T07:37:28Z Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis Chanane Wanapirak Supatra Sirichotiyakul Suchaya Luewan Kasemsri Srisupundit Fuanglada Tongprasert Theera Tongsong Agricultural and Biological Sciences Arts and Humanities © Georg Thieme Verlag KG Stuttgart.New York. Objective To determine the timeline of the first appearance of an increased CT ratio of fetuses with hemoglobin (Hb) Bart's disease. Materials and Methods A prospective longitudinal study was conducted on pregnancies at risk for fetal Hb Bart's disease. Sonographic markers including cardiothoracic (CT) ratio and middle cerebral artery peak systolic velocity (MCA-PSV) were serially assessed and recorded from the first trimester. The definite diagnosis of fetal Hb Bart's disease based on DNA analysis (CVS), or fetal Hb typing (HPLC; cordocentesis) was performed at the first appearance of an increased CT ratio. Results Of 275 pregnancies at risk, 64 fetuses were finally proven to be affected and life table analysis was performed. Most affected fetuses showed an increased CT ratio in late first trimester and early second trimester, with median time of the first appearance at 13 weeks and all affected fetuses were detected at 23 weeks or less. The CT ratio yielded a sensitivity of 100% at a gestational age of 23 weeks with a false-positive rate of 8%. MCA-PSV appeared later than CT ratio. Only 9.4% of affected cases developed abnormal MCA-PSV before an increased CT ratio. Conclusion The timeline of the first appearance of an increased CT ratio of fetuses with Hb Bart's disease was established. This may help us identify Hb Bart's disease among fetuses at risk in earlier gestation and proper schedules for serial ultrasound could be made more effectively. 2018-04-25T07:15:34Z 2018-04-25T07:15:34Z 2017-10-01 Journal 14388782 01724614 2-s2.0-85028853003 10.1055/s-0043-100627 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85028853003&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/47044
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Agricultural and Biological Sciences
Arts and Humanities
spellingShingle Agricultural and Biological Sciences
Arts and Humanities
Chanane Wanapirak
Supatra Sirichotiyakul
Suchaya Luewan
Kasemsri Srisupundit
Fuanglada Tongprasert
Theera Tongsong
Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis
description © Georg Thieme Verlag KG Stuttgart.New York. Objective To determine the timeline of the first appearance of an increased CT ratio of fetuses with hemoglobin (Hb) Bart's disease. Materials and Methods A prospective longitudinal study was conducted on pregnancies at risk for fetal Hb Bart's disease. Sonographic markers including cardiothoracic (CT) ratio and middle cerebral artery peak systolic velocity (MCA-PSV) were serially assessed and recorded from the first trimester. The definite diagnosis of fetal Hb Bart's disease based on DNA analysis (CVS), or fetal Hb typing (HPLC; cordocentesis) was performed at the first appearance of an increased CT ratio. Results Of 275 pregnancies at risk, 64 fetuses were finally proven to be affected and life table analysis was performed. Most affected fetuses showed an increased CT ratio in late first trimester and early second trimester, with median time of the first appearance at 13 weeks and all affected fetuses were detected at 23 weeks or less. The CT ratio yielded a sensitivity of 100% at a gestational age of 23 weeks with a false-positive rate of 8%. MCA-PSV appeared later than CT ratio. Only 9.4% of affected cases developed abnormal MCA-PSV before an increased CT ratio. Conclusion The timeline of the first appearance of an increased CT ratio of fetuses with Hb Bart's disease was established. This may help us identify Hb Bart's disease among fetuses at risk in earlier gestation and proper schedules for serial ultrasound could be made more effectively.
format Journal
author Chanane Wanapirak
Supatra Sirichotiyakul
Suchaya Luewan
Kasemsri Srisupundit
Fuanglada Tongprasert
Theera Tongsong
author_facet Chanane Wanapirak
Supatra Sirichotiyakul
Suchaya Luewan
Kasemsri Srisupundit
Fuanglada Tongprasert
Theera Tongsong
author_sort Chanane Wanapirak
title Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis
title_short Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis
title_full Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis
title_fullStr Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis
title_full_unstemmed Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis
title_sort appearance of abnormal cardiothoracic ratio of fetuses with hemoglobin bart's disease: life table analysis
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85028853003&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/47044
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