MATERNAL DIABETES-MELLITUS - WHICH VIEWS ARE ESSENTIAL FOR FETAL ECHOCARDIOGRAPHY

Objective: To determine which fetal echocardiography views are essenti al to detect the majority of cardiac defects in fetuses of women with diabetes mellitus. Methods: Fetal echocardiograms performed from Febru ary 1990 through May 1996 on insulin-requiring women with diabetes wer e reviewed. Individual component views of the examination were analyze d for the detection of fetal congenital heart defects. Sensitivity, sp ecificity, positive predictive value, and negative predictive value we re calculated. Multiple gestations and patients with additional risk f actors for congenital heart defects were excluded. Results: A total of 223 patients were included in the study. There were 11 (4.9%) congeni tal heart defects, eight of which were conotruncal. When the four-cham ber view and outflow tracts appeared normal, additional views such as the ductal and aortic arches did not detect a cardiac defect. The sens itivity of the four-chamber view for detecting an abnormal heart incre ased from 73% to 82% with the addition of the aortic outflow tract. Th ere were two false-negative and no false-positive diagnoses. Conclusio n: The four-chamber and outflow tracts are the essential views that wi ll detect most cardiac defects in fetuses of women with insulin-requir ing diabetes mellitus. (C) 1997 by The American College of Obstetricia ns and Gynecologists.