ArticleArchives of gynecology and obstetrics2025
Hemodynamic and developmental biomarkers enhance prenatal coarctation prediction: a validated multiparametric ultrasound model.
Article in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo develop and validate a prenatal prediction model for aortic coarctation (CoA) using morphologic, hemodynamic, and fetal growth parameters to enhance diagnostic accuracy and guide clinical decision-making.
methodEighty-three fetuses with suspected CoA were retrospectively analyzed. Key prenatal predictors were analyzed using multivariable logistic regression to construct a nomogram. Model performance was evaluated via area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA).
resultsOf the 83 fetuses, 28 (33.7%) were postnatally confirmed with CoA. The final model identified abdominal-to-head circumference ratio × 100% (β = 0.90, 95% CI 0.22-1.58), maximum aortic arch z-score (β = - 0.85, 95% CI - 1.50 to - 0.19), ventricular septal defect (OR = 1.85, 95% CI 1.02-3.53), and abnormal atrial hemodynamics (OR = 0.73, 95% CI 0.38-1.39) as significant predictors. The model achieved an AUC of 0.86 (95% CI 0.78-0.94), with calibration plots demonstrating strong agreement between predicted and observed probabilities. DCA confirmed clinical utility across a wide threshold range.
conclusionsThis nomogram enhances CoA prediction by integrating structural and functional ultrasound markers. It offers strong diagnostic performance and practical value for prenatal risk stratification, potentially reducing false positives and unnecessary interventions.
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