{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T11:20:28Z","timestamp":1793704828819,"version":"4.5.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2017,2,21]]},"abstract":"\n Background:<\/jats:title>\n Prenatal diagnosis of coarctation of the aorta (CoA) is still challenging and affected by high rates of false-positive diagnoses. The aim of this study was to ascertain the strength of association and to quantify the diagnostic accuracy of different ultrasound signs in predicting CoA prenatally.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Medline, Embase, CINAHL, and Cochrane databases were searched. Random-effects and hierarchical summary receiver operating characteristic model meta-analyses were used to analyze the data.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Seven hundred ninety-four articles were identified, and 12 (922 fetuses at risk for CoA) articles were included. Mean mitral valve diameter\n z<\/jats:italic>\n score was lower (\n P<\/jats:italic>\n <0.001) and the mean tricuspid valve diameter\n z<\/jats:italic>\n score was higher in fetuses with CoA than in those without CoA (\n P<\/jats:italic>\n =0.01). Mean aortic valve diameter\n z<\/jats:italic>\n score was lower in fetuses with CoA than in healthy fetuses (\n P<\/jats:italic>\n \u22640.001), but the ascending aorta diameter, expressed as\n z<\/jats:italic>\n score or millimeters, was similar between groups (\n P<\/jats:italic>\n =0.07 and 0.47, respectively). Mean aortic isthmus diameter\n z<\/jats:italic>\n scores measured either in sagittal (\n P<\/jats:italic>\n =0.02) or in 3-vessel trachea view (\n P<\/jats:italic>\n <0.001) were lower in fetuses with CoA. Conversely, the mean pulmonary artery diameter\n z<\/jats:italic>\n score, the right\/left ventricular and pulmonary artery\/ascending aorta diameter ratios were higher (\n P<\/jats:italic>\n <0.001,\n P<\/jats:italic>\n =0.02, and\n P<\/jats:italic>\n =0.02, respectively) in fetuses with CoA in comparison with controls, although aortic isthmus\/arterial duct diameter ratio was lower in fetuses with CoA than in those without CoA (\n P<\/jats:italic>\n <0.001). The presence of coarctation shelf and aortic arch hypoplasia were more common in fetuses with CoA than in controls (odds ratio, 26.0; 95% confidence interval, 4.42\u2013153;\n P<\/jats:italic>\n <0.001 and odds ratio, 38.2; 95% confidence interval, 3.01\u2013486;\n P<\/jats:italic>\n =0.005), whereas persistent left superior vena cava (\n P<\/jats:italic>\n =0.85), ventricular septal defect (\n P<\/jats:italic>\n =0.12), and bicuspid aortic valve (\n P<\/jats:italic>\n =0.14) did not carry an increased risk for this anomaly. Multiparametric diagnostic models integrating different ultrasound signs for the detection of CoA were associated with an increased detection rate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The detection rate of CoA may improve when a multiple-criteria prediction model is adopted. Further large multicenter studies sharing the same imaging protocols are needed to develop objective models for risk assessment in these fetuses.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/circulationaha.116.024068","type":"journal-article","created":{"date-parts":[[2016,12,29]],"date-time":"2016-12-29T20:10:26Z","timestamp":1483042226000},"page":"772-785","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":173,"title":["Risk Factors for Coarctation of the Aorta on Prenatal Ultrasound"],"prefix":"10.1161","volume":"135","author":[{"given":"Alessandra","family":"Familiari","sequence":"first","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Morlando","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Khalil","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven-Erik","family":"Sonesson","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Scala","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rizzo","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gelsomina","family":"Del Sordo","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Vassallo","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Elena Flacco","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamberto","family":"Manzoli","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lanzone","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Acharya","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"D\u2019Antonio","sequence":"additional","affiliation":[{"name":"From Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy (A.F., G.D.S., C.V., A.L., G.S.); Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Italy (M.M.); Fetal Medicine Unit, Saint George\u2019s Hospital, London, United Kingdom (A.K.); Pediatric Cardiology Unit, Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden (S.S.-E.); Department of Obstetrics and Gynecology,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.057182"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(47)90002-1"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.87.1.67"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.06.016"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2710"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90429-4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2010.01380.x"},{"key":"e_1_3_3_9_2","volume-title":"Systematic Reviews: CRD\u2019s Guidance for Undertaking Reviews in Health Care","author":"NHS Centre for Reviews and Dissemination","year":"2009","unstructured":"NHS Centre for Reviews and Dissemination. Systematic Reviews: CRD\u2019s Guidance for Undertaking Reviews in Health Care. York, UK: University of York, York Publishing Services Ltd; 2009."},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","unstructured":"Moher D Shamseer L Clarke M Ghersi D Liberati A Petticrew M Shekelle P Stewart LA; and PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1. http:\/\/www.prisma-statement.org\/ Accessed November 20 2015.","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_3_3_11_2","unstructured":"Wells GA Shea B O\u2019Connell D Peterson J Welch V Losos M Tugwell P. Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. The Ottowa Hospital Research Institute. http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. Accessed February 10 2016."},{"key":"e_1_3_3_12_2","volume-title":"Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 1.0","author":"Macaskill P","year":"2010","unstructured":"Macaskill P, Gatsonis C, Deeks JJ, Harbord RM, Takwoingi Y. Chapter 10: Analysing and presenting results. , Deeks JJ, Bossuyt PM, Gatsonis C, Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 1.0. The Cochrane Collaboration; 2010. http:\/\/srdta.cochrane.org\/. January 15, 2016."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00177-X"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.942"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4753"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/echo.13140"},{"key":"e_1_3_3_17_2","first-page":"475","article-title":"The role of ventricular disproportion, aortic, and ductal isthmus ultrasound measurements for the diagnosis of fetal aortic coarctation, in the third trimester of pregnancy.","volume":"17","author":"M\u0103rginean C","year":"2015","unstructured":"M\u0103rginean C, M\u0103rginean CO, Muntean I, Tog\u0103nel R, Void\u0103zan S, Gozar L. The role of ventricular disproportion, aortic, and ductal isthmus ultrasound measurements for the diagnosis of fetal aortic coarctation, in the third trimester of pregnancy. Med Ultrason. 2015;17:475\u2013481.","journal-title":"Med Ultrason"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1153-1"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1168-7"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4452"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2010.29.2.325"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.10.1313"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1027556"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.787598"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.033027"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002460010206"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6270"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2704"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15914"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.068"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013051"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.116.024068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:03:00Z","timestamp":1715569380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.116.024068"}},"subtitle":["A Systematic Review and Meta-Analysis"],"short-title":[],"issued":{"date-parts":[[2017,2,21]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,2,21]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.116.024068"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.116.024068","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,21]]},"assertion":[{"value":"2016-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}