Fetal ultrasound screening for the diagnosis of interventricular communications

Introduction: The interventricular communication is a "hole" in the interventricular septum creating a communication and a passage of blood from the left ventricle to the right ventricle.

Objective: Determine the sensitivity and specificity of ultrasonography in the diagnosis of interventricular communication, through anatomical-ultrasound confrontation.

Materials and Methods: Retrospective study conducted at the Maternity and Neonatal Center of Tunis in the Embryo – foetopathology department, referencing all cases of congenital heart diseases, in particular, cases of ventricular septal defect, over a period of 2 years, from January 2011 to December 2012.

Results: Ninety-five cases of congenital heart disease, which represents a frequency of 5.73%, were recorded in 1482 fœto-pathologic examinations. Out of the 85 detected heart diseases, 42 were ventricular septal defect, which represents a frequency of 49%. The sensitivity of ultrasound in the detection of VSD was 40.47% and specificity was 97.67%. Ultrasound has a good positive predictive value in the detection of VSD of 94.44%. Its negative predictive value was 62.68%. In our series, the combination of VSD and other heart diseases was found in 43% of cases. It was mainly represented by the truncus arteriosus in 4 cases and the ASD in 4 cases. The extracardiac malformations associated with VSD were noticed in 83% of cases, mainly craniofacial anomalies in 3% of cases and anomalies of the extremities in 36% of cases.

Conclusion: The ventricular septal defect is a common congenital heart disease. The antenatal diagnosis can lead to look for other associated abnormalities or chromosomal aberrations and allows us to determine a therapeutic strategy.