Abstract
Background: The detection rate of congenital heart defects is
barely acceptable. Since 2016, the French National Conference on
Obstetrical and Foetal Ultrasound updated its recommendations by the
inclusion of an examination of the left ventricular outflow tract (LVOT)
in the second and third trimester of pregnancy.
Objectives: This study aimed on the one hand to evaluate the
practices related to the realization of the LVOT in the setting of fetal
echocardiography in low-risk populations, and on the other hand to study
the possible modifications of the practices secondary to the
introduction of quality criteria.
Study Design: We conducted a multicentric, retrospective and
prospective, descriptive, longitudinal study divided into three distinct
periods: before 2016, in 2017, and in 2020. Seven quality criteria were
investigated and rated from 0 to 1 for LVOT screening. Files were
randomly selected from three centers, then average total and specific
scores were calculated.
Results: LVOT images were present in ultrasound reports in more
than 93% of cases. Before 2016, the average quality score was 5.49/7
(95% CI: 5.36-5.62), in 2017 5.91/7 (95% CI: 5.80-6.03), and in 2020
5.70/7 (95% CI: 5.58-5.82) for the three centers. There was no
significant difference following the introduction of the quality
criteria; 2017 vs. 2020, p = 0.054. Kappa coefficients of the inter- and
intra-operator variables were all within 0.601 and 1.
Conclusion: Left ventricular outflow tract images were present
in most of ultrasound reports. The introduction of the proposed quality
criteria is not associated with a significant change in practice.