{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:58:55Z","timestamp":1792684735359,"version":"4.5.0"},"reference-count":58,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,9]],"date-time":"2024-03-09T00:00:00Z","timestamp":1709942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the diagnostic accuracy of prenatal ultrasound in detecting coarctation of the aorta (CoA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An individual participant data meta\u2010analysis was performed to report on the strength of association and diagnostic accuracy of different ultrasound signs in detecting CoA prenatally. MEDLINE, EMBASE and CINAHL were searched for studies published between January 2000 and November 2021. Inclusion criteria were fetuses with suspected isolated CoA, defined as ventricular and\/or great vessel disproportion with right dominance on ultrasound assessment. Individual participant\u2010level data were obtained by two leading teams. PRISMA\u2010IPD and PRISMA\u2010DTA guidelines were used for extracting data, and the QUADAS\u20102 tool was used for assessing quality and applicability. The reference standard was CoA, defined as narrowing of the aortic arch, diagnosed after birth. The most commonly evaluated parameters on ultrasound, both in B\u2010mode and on Doppler, constituted the index test. Summary estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and likelihood ratios were computed using the hierarchical summary receiver\u2010operating\u2010characteristics model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The initial search yielded 72 studies, of which 25 met the inclusion criteria. Seventeen studies (640 fetuses) were included. On random\u2010effects logistic regression analysis, tricuspid valve\/mitral valve diameter ratio\u2009&gt;\u20091.4 and\u2009&gt;\u20091.6, aortic isthmus\/arterial duct diameter ratio\u2009&lt;\u20090.7, hypoplastic aortic arch (all <jats:italic>P\u2009&lt;<\/jats:italic>\u20090.001), aortic isthmus diameter <jats:italic>Z<\/jats:italic>\u2010score of &lt;\u2009\u22122 in the sagittal (<jats:italic>P\u2009=<\/jats:italic>\u20090.003) and three\u2010vessel\u2010and\u2010trachea (<jats:italic>P\u2009&lt;<\/jats:italic>\u20090.001) views, pulmonary artery\/ascending aorta diameter ratio &gt;\u20091.4 (<jats:italic>P\u2009=<\/jats:italic>\u20090.048) and bidirectional flow at the foramen ovale (<jats:italic>P\u2009=<\/jats:italic>\u20090.012) were independently associated with CoA. Redundant foramen ovale was inversely associated with CoA (<jats:italic>P\u2009=<\/jats:italic>\u20090.037). Regarding diagnostic accuracy, tricuspid valve\/mitral valve diameter ratio\u2009&gt;\u20091.4 had a sensitivity of 72.6% (95%\u2009CI, 48.2\u201388.3%), specificity of 65.4% (95%\u2009CI, 46.9\u201380.2%) and DOR of 5.02 (95%\u2009CI, 1.82\u201313.9). The sensitivity and specificity values were, respectively, 75.0% (95%\u2009CI, 61.1\u201386.0%) and 39.7% (95%\u2009CI, 27.0\u201353.4%) for pulmonary artery\/ascending aorta diameter ratio\u2009&gt;\u20091.4, 47.8% (95%\u2009CI, 14.6\u201383.0%) and 87.6% (95%\u2009CI, 27.3\u201399.3%) for aortic isthmus diameter <jats:italic>Z<\/jats:italic>\u2010score of &lt;\u2009\u20132 in the sagittal view and 74.1% (95%\u2009CI, 58.0\u201385.6%) and 62.0% (95%\u2009CI, 41.6\u201378.9%) for aortic isthmus diameter <jats:italic>Z<\/jats:italic>\u2010score of &lt;\u2009\u20132 in the three\u2010vessel\u2010and\u2010trachea view. Hypoplastic aortic arch had a sensitivity of 70.0% (95%\u2009CI, 42.0\u201388.6%), specificity of 91.3% (95%\u2009CI, 78.6\u201396.8%) and DOR of 24.9 (95%\u2009CI, 6.18\u2013100). The diagnostic yield of prenatal ultrasound in detecting CoA did not change significantly when considering multiple categorical parameters. Five of the 11 evaluated continuous parameters were independently associated with CoA (all <jats:italic>P\u2009&lt;<\/jats:italic>\u20090.001) but all had low\u2010to\u2010moderate diagnostic yield.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Several prenatal ultrasound parameters are associated with an increased risk for postnatal CoA. However, diagnostic accuracy is only moderate, even when combinations of parameters are considered. \u00a9 2024 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27576","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T10:46:26Z","timestamp":1704883586000},"page":"446-456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Diagnostic accuracy of prenatal ultrasound in coarctation of aorta: systematic review and individual participant data meta\u2010analysis"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9456-4100","authenticated-orcid":false,"given":"C.","family":"Villala\u00edn","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitario 12 de Octubre Complutense University  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n del Hospital 12 de Octubre (imas12)  Madrid Spain"},{"name":"Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS network), RD21\/0012\/0024  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7546-8025","authenticated-orcid":false,"given":"F.","family":"D'Antonio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Chieti  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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