Clinical Significance of Fetal Cardiac Axis in Screening of Fetal Cardiac and Extracardiac Intrathoracic Anomaly

Kim, Kyung Soo; Park, Yong Won; Cho, Jae Sung; Kim, Tae Yoon; Choi, Hyung Min; Lim, Young Koo; Kim, Jae Wook

Abstract

OBJECTIVES
The objective of this study is to investigate a possible role for fetal cardiac axis in prenatal screening of congenital cardiac or extracardiac intrathoracic anomaly. Introduction: The incidence of the congenital heart disease is reported to be 8 per 1000 live births. The congenital heart disease is the most common major anomaly in newborn, and significantly affects perinatal morbidity and mortality. Because about 90% of congenital heart disease occurs in fetus without risk factors, it is important to screen congenital heart disease in low risk patients for the congenital heart disease. METHOD: 48 cases of cardiac(38 cases) and extracardiac intrathoracic(10 cases) anomaly and 205 cases for control were evaluated for measurement of cardiac axis and analyzed by Student`s t-test and correlation analysis with SPSS/PC+ packages.
RESULTS
The mean cardiac axis of control group was 39.4degrees (SD: 9.2degrees, range: 20degrees ~ 65degrees), and in the lesion group it was 42.1degrees (SD: 28.9degrees, range: -34degrees ~ 127degrees). If we use mean cardiac axis+/-2SD of normal fetuses as a range of normal cardiac axis(21degrees ~ 58degrees), 16/48(33.3%) of the congeital heart disease or extracardiac intrathoracic anomaly will be detected and specificity, positive predictive value, negative predictive value of the fetal cardiac axis in screening cardiac or intrathoracic anomaly will be 96.6%, 69.6%, 86.1%, respectively.
CONCLUSION
The fetal cardiac axis may be a useful parameter in screening fetal cardiac or extracardiac intrathoracic anomaly, and could be used clinically as a parameter for evaluation of the four-chamber view of the heart.