{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:09:20Z","timestamp":1791864560429,"version":"4.3.4"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,5]],"date-time":"2012-12-05T00:00:00Z","timestamp":1354665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,1]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To identify prenatal echocardiographic markers that could predict the need for neonatal intervention in fetuses with right ventricular outflow tract obstruction.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a retrospective study of 52 fetuses with right ventricular outflow tract obstruction. Echocardiograms were evaluated for fetuses with either two\u2010ventricle anatomy with a large ventricular septal defect or single\u2010ventricle anatomy. Fetuses with pulmonary atresia were excluded. Parameters were compared between groups that did and did not require an intervention at age <\u200930\u2009days.<\/jats:p><\/jats:sec>Results<\/jats:title>Fifty\u2010two fetuses were studied; 20 (38%) underwent neonatal intervention and 32 (62%) did not. The most common diagnosis was tetralogy of Fallot (n<\/jats:italic>\u2009=\u200932). Fetuses with two ventricles that required an intervention had lower pulmonary valve diameter Z<\/jats:italic>\u2010score (PV<\/jats:styled-content>\u2010Z\u2010score) (\u22124.8\u2009\u00b1\u20092.1 vs<\/jats:italic> \u22122.6\u2009\u00b1\u20091.1; P<\/jats:italic>\u2009=\u20090.0002) and lower pulmonary valve to aortic valve annular diameter ratio (PV<\/jats:styled-content>\/AoV<\/jats:styled-content>) (0.53\u2009\u00b1\u20090.15 vs 0.66\u2009\u00b1\u20090.1; P<\/jats:italic>\u2009=\u20090.003). Using a PV<\/jats:styled-content>\/AoV<\/jats:styled-content> ratio of\u2009<\u20090.6 or a PV<\/jats:styled-content>\u2010Z\u2010score of\u2009<\u2009\u22123 at final echocardiographic examination was highly sensitive (92%) but poorly specific (50%), whereas classifying direction of flow in the ductus arteriosus as either normal (all pulmonary\u2010to\u2010aorta) or abnormal (aorta\u2010to\u2010pulmonary or bidirectional) was both highly sensitive (100%) and specific (95%) for predicting the need for a neonatal intervention. Parameters for the single\u2010ventricle cohort did not reach statistical significance.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Analysis of the pulmonary outflow tract and ductus arteriosus flow in the fetus with complex congenital heart disease can aid in identifying those that will require a neonatal intervention to augment pulmonary blood flow. This has important implications for the planning of delivery strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.11196","type":"journal-article","created":{"date-parts":[[2012,5,17]],"date-time":"2012-05-17T19:15:18Z","timestamp":1337282118000},"page":"47-53","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Pulmonary outflow tract obstruction in fetuses with complex congenital heart disease: predicting the need for neonatal intervention"],"prefix":"10.1002","volume":"41","author":[{"given":"M. D.","family":"Quartermain","sequence":"first","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Glatz","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. D.","family":"Elias","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Tian","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Rychik","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,12,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.9.1269"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.7.916"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00446-7"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.81.6.661"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.63"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.09010025.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00422-M"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951103000477"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2597"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0828-282X(10)70330-5"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.11196","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.11196","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.11196","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.11196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T16:28:41Z","timestamp":1692548921000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.11196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,5]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1002\/uog.11196"],"URL":"https:\/\/doi.org\/10.1002\/uog.11196","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12,5]]},"assertion":[{"value":"2012-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-12-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}