comparison of diagnostic markers of aortic coarctation in prenatal and postnatal echocardiography

Background: the prenatal diagnosis of coarctation of aorta (coa) remains a major challenge, as the false-positive diagnosis is fairly common. the purpose of this study was to find some useful prenatal sonographic markers compatible with the postnatal diagnosis of coa. methods: the study included fetuses suspected of coa in the second and third-trimester ultrasound tests. all cases were examined by fetal echocardiography at a single ultrasound clinic between 2019 and 2020. the proportion of right and left ventricular size was assessed and ductal/isthmus diameter ratio was measured. a comparison was drawn between the results of neonates with neonatal coa and neonates without coa. results: of 20 fetuses with suspected prenatal coa, 3 (15%) had neonatal coa. the mean ductal/isthmus ratio was significantly higher in the neonates with coa (1.96 vs. 1.46; p< 0.001). the diagnostic power of ductal/isthmus ratio to detect coa with a cut point of 1.53 had a sensitivity and specificity of 100% and 70.6%, respectively, a positive and negative predictive value of 37.5% and 100%, respectively, and an overall accuracy of 75%. conclusion: the ductal/isthmus ratio diameter and ventricular disproportion are significant sonographic markers for the prenatal diagnosis of coa, and the ductal/isthmus ratio has high sensitivity and specificity compared to postnatal findings.