Evidence map›Paper›PMID 38320542›Full record

Observational studyFetal diagnosis and therapy2024

Prenatal Diagnosis of Fetal Aqueductal Stenosis: A Multicenter Prospective Observational Study through the North American Fetal Therapy Network.

Stephen P Emery, Samia Lopa, Erika Peterson, Angie C Jelin, Marjorie C Treadwell, Juliana Gebb, Henry L Galan, Eric Bergh, Amanda Criebaum, Amelia McLennan and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Fetal diagnosis and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Stephen P EmeryDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, UPMC Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA.
Samia LopaDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, UPMC Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA.
Erika PetersonDepartment of Obstetrics and Gynecology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.
Angie C JelinDepartment of Gynecology and Obstetrics, Johns Hopkins University, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Marjorie C TreadwellDepartment of Obstetrics and Gynecology, Wayne State University School of Medicine, University of Michigan Hospital, Ann Arbor, Michigan, USA.
Juliana GebbDivision of Pediatric General, Fetal and Thoracic Surgery, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Henry L GalanDepartment of Obstetrics and Gynecology, University of Colorado School of Medicine, Children's Hospital Colorado, Denver, Colorado, USA.
Eric BerghDepartment of Obstetrics and Gynecology, University of Texas at Houston, Children's Memorial Hermann Hospital, Houston, Texas, USA.
Amanda CriebaumDepartment of Obstetrics and Gynecology, St. Louis Fetal Care Institute, St. Louis, Missouri, USA.
Amelia McLennanDepartment of Obstetrics and Gynecology, University of California Davis, UC Davis Medical Center, Sacramento, California, USA.
Joseph LillegardDepartment of Surgery, Children's Minnesota, Minneapolis, Minnesota, USA.
Yair J BlumenfeldDepartment of Obstetrics and Gynecology, Stanford University, Stanford Medicine Children's Health Stanford, Palo Alto, California, USA.

Funding

Single gene pathogenic variants associated with BEEC (Bladder Exstrophy, Epispadias, Complex)K23DK119949 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI JELIN, ANGIE CHILD · 2019 to 2023
$1.1M
NORTH AMERICAN FETAL THERAPY NETWORK BIANNUAL SCIENTIFIC MEETINGSR13HD059293 · NICHD · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI JOHNSON, ANTHONY · 2009 to 2018
$60k
NICHD NIH HHS R13 HD059293NIDDK NIH HHS K23 DK119949
6 · The paper itself

Abstract

introductionA critical component of an evidence-based reassessment of in-utero intervention for fetal aqueductal stenosis (fetal AS) is determining if the prenatal diagnosis can be accurately made at a gestational age amenable to in-utero intervention.

methodsA multicenter, prospective, observational study was conducted through the North American Fetal Therapy Network (NAFTNet). Pregnancies complicated by severe central nervous system (CNS) ventriculomegaly (lateral ventricle diameter >15 mm) not secondary to a primary diagnosis (myelomeningocele, encephalocele, etc.) were recruited at diagnosis. Imaging and laboratory findings were recorded in an online REDCap database. After evaluation, investigators were asked to render their degree of confidence in the diagnosis of fetal AS. The prenatal diagnosis was compared to the postnatal diagnosis obtained through neonatal neuroimaging. Performance characteristics of ultrasound and magnetic resonance imaging (MRI) were calculated, as was the mean gestational age at diagnosis.

resultsBetween April 2015 and October 2022, eleven NAFTNet centers contributed 64 subjects with severe fetal CNS ventriculomegaly. Of these, 56 had both prenatal and postnatal diagnoses recorded. Ultrasound revealed 32 fetal AS true positives, 4 false positives, 7 false negatives, and 13 true negatives, rendering a sensitivity of 0.82, a specificity of 0.76, a positive predictive value of 0.89, and a negative predictive value of 0.65. The mean gestational age at diagnosis by ultrasound was 25.5 weeks (std +/- 4.7 weeks). The proportion of agreement (true positive + true negative/n) was highest at 24 weeks gestation. For fetal MRI (n = 35), the sensitivity for fetal AS was 0.95, specificity was 0.69, positive predictive value was 0.84, and negative predictive value was 0.90. MRI was performed at 25 weeks on average.

conclusionThe prenatal diagnosis of fetal AS can be made with accuracy at a gestational age potentially amenable to in-utero intervention. Only 7% of subjects were incorrectly diagnosed prenatally with fetal AS by ultrasound and 11% by MRI. Diagnostic accuracy of fetal AS will likely improve with increased experience.

Indexed as

HydrocephalusPrenatal DiagnosisUltrasonography, PrenatalAdultFemaleFetal DiseasesFetal TherapiesGestational AgeHumansMagnetic Resonance ImagingPregnancyProspective StudiesFetal aqueductal stenosisHydrocephalusMagnetic resonance imagingPrenatal diagnosisUltrasoundVentriculomegaly

Identifiers

PMID38320542
PMCPMC11844214

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.