Assessment of the Diagnostic Value of Major Cardiac Defects through Ultrasound in the First Trimester and Its Correlation with Increased Nuchal Translucency, Tricuspid Regurgitation, and Abnormal Ductus Venosus Flow

Congenital heart defects (CHDs) are a leading cause of mortality and morbidity in neonates. Early detection is crucial for timely intervention and improved outcomes. This study investigated the diagnostic value of first-trimester ultrasound in detecting CHDS and its correlation with increased nuchal translucency (NT), tricuspid regurgitation (TR), and abnormal ductus venosus (DV) flow. Methods: This cross-sectional study included all pregnant women who underwent first-trimester screening ultrasound between ۲۰۱۷ and ۲۰۲۴ by an obstetrician or radiologist at Forghani Hospital and were referred for fetal echocardiography at ۱۶-۱۸ weeks gestation at Hazrat Masoumeh Hospital, Qom, Iran. All cases underwent postnatal neonatal echocardiography. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of increased NT, TR, and abnormal DV flow in detecting CHDs were calculated. Results: The sensitivity, specificity, PPV, and NPV of increased NT for detecting CHDS were ۷۴.۷%, ۹۸.۳%, ۹۰.۹%, and ۹۴.۷%, respectively. For TR, these values were ۷۱.۹%, ۹۷.۷%, ۸۷.۵%, and ۹۴.۱%, respectively. For abnormal DV flow, the values were ۸۲.۲%, ۹۵.۱%, ۷۸.۵%, and ۹۶.۱%, respectively. The diagnostic accuracy of NT, TR, and abnormal DV flow for detecting CHDS was ۹۴.۱%, ۹۳.۱%, and ۹۲.۸%, respectively. Conclusion: Targeted fetal ultrasound in the first trimester is a valuable diagnostic tool for detecting CHDs. Early detection can contribute to improved neonatal outcomes.