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  • Title: Performance of Fetal Cardiac Volume Derived from VOCAL (Virtual Organ Computer-Aided AnaLysis) in Predicting Hemoglobin (Hb) Bart's Disease.
    Author: Thammavong K, Luewan S, Tongsong T.
    Journal: J Clin Med; 2021 Oct 11; 10(20):. PubMed ID: 34682774.
    Abstract:
    OBJECTIVE: To determine the performance of fetal cardiac volume (CV) in the detection of fetal Hb Bart's disease among fetuses at risk at 18-22 weeks of gestation and to compare the performance with those of cardiothoracic diameter ratio (CTR) and middle cerebral artery peak systolic velocity (MCA-PSV). METHODS: Fetuses at risk of Hb Bart's disease between 18 and 22 weeks of gestation prospectively underwent echocardiography with acquisition of the volume datasets (VDS) of fetal heart, using 4D-cardiac STIC. Subsequently, off-line analysis was blindly performed to measure cardiac volume using the VOCAL technique. RESULTS: A total of 502 fetuses at risk meeting the inclusion criteria were included in the analysis, consisting of 117 (23.3%) fetuses with Hb Bart's disease and 385 (76.7%) unaffected fetuses. The mean (±SD) gestational age at the time of ultrasound examination was 19.70 ± 1.3 weeks. In predicting fetal Hb Bart's disease, CV, using a cut-off Z-score of 1.7, had a sensitivity of 94.9% and specificity of 94.0%. The performance of CV was slightly better than that of CTR but very superior to that of MCA-PSV (areas under curve: 0.988, 0.974 and 0.862, respectively). CONCLUSIONS: Fetal CV has a very high performance in predicting fetal Hb Bart's disease at mid-pregnancy, comparable with CTR and much better than MCA-PSV.
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