Open Access

ARTICLE

Fetal heart size measurements as new predictors of homozygous α-thalassemia-1 in mid-pregnancy

Xinyan Li¹, Xiaoxia Qiu¹, Huan Huang¹, Yili Zhao², Xueqin Li¹, Meng Li¹, Xiaoxian Tian¹

1 Department of Ultrasonography, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People’s Republic of China
2 Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA

* Corresponding Author: Xinyan Li, Department of Ultrasonography, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, 225 Xinyang Road, Nanning, Guangxi, China 530003. Email:

Congenital Heart Disease 2018, 13(2), 282-287. https://doi.org/10.1111/chd.12568

Abstract

Objective: To evaluate the efficacy of using fetal heart size measurements derived from axial echocardiography to predict homozygous α-thalassemia-1.
Design: Prospective diagnostic study.
Setting: The carrier rate of α-thalassemia-1 (–/αα) in China’s Guangxi Zhuang Autonomous Region is approximately 15%. If both parents are carriers, the risk of homozygous a-thalassemia-1 in one pregnancy is 25%.
Patients: Singleton mid-pregnancies at risk of homozygous α-thalassemia-1 were enrolled.
Outcome Measures: Fetal heart measurements, including heart diameter (HD), heart length (HL), heart circumference (HC), and heart area (HA), were measured. The z-scores for these heart parameters were then calculated separately based on previously constructed z-score models. Finally, the accuracy of these predictive variables was analyzed and compared to that achieved by cardiothoracic ratio (CTR) using a receiver operating characteristic (ROC) curves analysis.
Results: A total of 214 singleton pregnancies were recruited. The discriminatory power of HA and HD z-scores was better (z-test P< .01) while that of HC and HL z-scores was comparable to (z-test P>.05) that of CTR. HD combined with HA z-scores had the highest sensitivity (100%), and the specificity of HD and/or HA z-scores was 100%.
Conclusion: Fetal heart size measurements are novel, effective and noninvasive predictors of homozygosity for α-thalassemia-1 in mid-pregnancy. The discriminatory power of HD and HA zscores was better than while that of HC and HL z-scores was comparable to that of CTR. Further investigation is needed to understand the effectiveness of these predictors.

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