Joinau-Zoulovits Félicia, Bouzidi Anissa, Etienne Françoise, Levêque Christine
Department of Obstetrics and Gynecology, Saint-Denis Hospital Center, 93205 Saint-Denis, France.
Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU, 31300 Toulouse, France.
Medicina (Kaunas). 2025 Jul 31;61(8):1391. doi: 10.3390/medicina61081391.
: Doppler abnormalities in the ductus venosus (DV) during the first trimester can serve as an early marker for the detection of congenital heart defects (CHDs), but the feasibility of systematically assessing the DV remains underexplored. This study aimed to evaluate the feasibility of performing DV assessments during routine first-trimester ultrasound screenings. : A multicenter, prospective, and descriptive study was conducted, including singleton pregnancies undergoing routine ultrasound screening between 11 + 0 and 13 + 6 weeks of gestation. Sonographers were instructed to acquire DV Doppler images during the scan, and each image was blindly reviewed by an expert using predefined quality criteria. The images were categorized as "good", "medium", or "unsatisfactory", and feasibility was defined as the proportion of "good" images. Factors associated with feasibility were analyzed, including sonographer satisfaction, the Herman score and the acquisition time. : Of the 87 patients included in this study, a suitable DV Doppler image was feasible in 58.6% of cases. The feasibility was significantly higher when the sonographer was satisfied with the image, when the Herman score exceeded seven ( = 0.01), and when the acquisition time was less than five minutes. A strong correlation was observed between the expert's assessment and the sonographer's satisfaction. However, the gestational age, maternal BMI, parity, and operator-perceived image quality were not significantly associated with feasibility. : The Doppler assessment of the ductus venosus during first-trimester ultrasound screening is feasible and reproducible in routine clinical practice without significantly increasing the examination time. This suggests DV measurements to enhance the early nuchal translucency measurement to enhance the early detection of congenital heart defects during the first trimester.
孕早期静脉导管(DV)的多普勒异常可作为先天性心脏病(CHD)检测的早期标志物,但系统评估DV的可行性仍未得到充分探索。本研究旨在评估在常规孕早期超声筛查中进行DV评估的可行性。:进行了一项多中心、前瞻性描述性研究,纳入妊娠11 + 0至13 + 6周期间接受常规超声筛查的单胎妊娠。指导超声检查人员在扫描过程中获取DV多普勒图像,由一名专家使用预先定义的质量标准对每张图像进行盲法评估。图像分为“良好”、“中等”或“不满意”,可行性定义为“良好”图像的比例。分析与可行性相关的因素,包括超声检查人员的满意度、赫尔曼评分和采集时间。:在本研究纳入的87例患者中,58.6%的病例可获得合适的DV多普勒图像。当超声检查人员对图像满意、赫尔曼评分超过7分(P = 0.01)且采集时间少于5分钟时,可行性显著更高。专家评估与超声检查人员的满意度之间存在强相关性。然而,孕周、孕妇体重指数、产次和操作人员感知的图像质量与可行性无显著相关性。:孕早期超声筛查期间对静脉导管进行多普勒评估在常规临床实践中是可行且可重复的,且不会显著增加检查时间。这表明进行DV测量以加强早期颈部透明带测量,从而在孕早期加强对先天性心脏病的早期检测。