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The left outflow tract in foetal echocardiography screening: an audit of practices and quality criteria.
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  • Edwin Quarello,
  • Maud REGOUIN,
  • Julien MANCINI,
  • Antoine LAFOUGE,
  • Nathalie FONTAINE,
  • Stéphanie ROUSSIN,
  • Jimmy GUICHARD,
  • Coralie DUMONT
Edwin Quarello
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Maud REGOUIN
GHSR
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Julien MANCINI
AMU
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Antoine LAFOUGE
Cabinet Hyères
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Nathalie FONTAINE
GHSR
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Stéphanie ROUSSIN
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Jimmy GUICHARD
Cabinet d’échographie gynécologique et obstétricale
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Coralie DUMONT
GHSR
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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.