{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T19:13:32Z","timestamp":1775934812457,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"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":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Current guidelines in fetal echocardiography recommend serial evaluation every 4\u2009weeks for single\u2010ventricle lesions. However, there are limited data on the type and frequency of <jats:italic>in\u2010utero<\/jats:italic> cardiac changes seen on fetal echocardiograms (FEs) based on the type of single\u2010ventricle lesion. We aimed to evaluate the utility of serial FEs in detecting cardiac changes during gestation and how these changes impact  postnatal management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of all FEs for fetuses diagnosed with a single\u2010ventricle lesion at the Children's Healthcare of Atlanta,  between  January 2012 and  January 2023. All patients included in the study had two or more FEs and were evaluated for <jats:italic>in\u2010utero<\/jats:italic> cardiac changes based on eight cardiac categories: atrioventricular (AV) valve regurgitation; systemic ventricular dysfunction; ductus arteriosus flow; atrial\u2010level restriction; umbilical artery Doppler pattern; umbilical vein Doppler pattern; evidence of hydrops; and evidence of arrhythmias. All <jats:italic>in\u2010utero<\/jats:italic> cardiac changes were classified into three categories: improving, worsening or critical. Any changes noted on serial FEs that altered the fetal cardiac diagnosis were also recorded. Fisher's exact test was used to determine whether the proportion of fetuses with <jats:italic>in\u2010utero<\/jats:italic> cardiac changes differed significantly between different segmental findings and single\u2010ventricle lesion subtype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 721 FEs were performed for 248 patients over the 11\u2010year study period. The majority of fetuses had hypoplastic left heart syndrome (HLHS) (63.7%) and most changes were seen in the third trimester (median gestational age, 29.3 (range, 17.4\u201338.4)\u2009weeks). <jats:italic>In\u2010utero<\/jats:italic> cardiac changes observed on serial FEs were reported in 38 (15.3%) fetuses, with a total of 42 changes noted throughout the study period. However, only eight (3.2%) fetuses had a critical change that impacted  perinatal management. All  eight fetuses had HLHS, of which the majority developed hydrops (4\/8) or atrial\u2010level restriction (3\/8). In addition, there were 34 non\u2010critical changes seen in 30 (12.1%) fetuses, largely in the form of intermittent premature atrial contractions, AV valve regurgitation or ventricular dysfunction. There were 12 (2.5%) follow\u2010up FEs that resulted in a change to the fetal cardiac diagnosis, confirmed by postnatal echocardiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In fetuses with single\u2010ventricle lesions, there was a low rate of <jats:italic>in\u2010utero<\/jats:italic> cardiac changes that led to alterations in perinatal management. However, fetuses with HLHS were most likely to develop critical changes affecting delivery\u2010room management, often in the form of atrial\u2010level restriction and\/or evolving hydrops. It is important to consider these factors when considering the timing of visits for families who face a prenatal diagnosis of a single\u2010ventricle lesion. \u00a9 2025 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.29206","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T12:29:06Z","timestamp":1743337746000},"page":"575-580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Utility of serial fetal echocardiograms in detecting <i>in\u2010utero<\/i> changes for single\u2010ventricle lesions: an 11\u2010year experience"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-4574","authenticated-orcid":false,"given":"S. S.","family":"Ro","sequence":"first","affiliation":[{"name":"Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Saini","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Morrow","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Ketchum","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Kreeger","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Michelfelder","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7674"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.9.1269"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.04.014"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.534180"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.09.043"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.12.018"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199111000-00017"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)90763-7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90611-C"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2022.02.015"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27575"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.11.119"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.3538"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-015-3514-6"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-021-05061-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2015.07.005"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.06.017"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15123"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23740"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2024.08.012"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0610-4"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010394"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1601-1"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26240"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0633-3331"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2012.00706.x"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd10090394"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0912-1"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1874909"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010024\u201003520\u2010x"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.03.001"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.29206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T04:16:55Z","timestamp":1755749815000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.29206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":33,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/uog.29206"],"URL":"https:\/\/doi.org\/10.1002\/uog.29206","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,27]]},"assertion":[{"value":"2024-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}