The tetralogy of fallot

Introduction:

Tetralogy of fallot (TOF) is a congenital heart defect classically described like a four anatomical heart abnormalities. It's the most frequent cyanotic heart defect and the most common cause of blue baby syndrome due to right to left syndrome.

Objective:

Determine the sensitivity and specificity of ultrasonography in the diagnosis of tetralogy of fallot, through anatomical-ultrasound confrontation.

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 tetralogy of fallot, 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 foeto-pathologic examinations. Out of the 85 detected heart diseases, 9 were tetralogy of fallot, which represents a frequency of 10%. The sensitivity of ultrasound in the detection of TOF was 55.55% and specificity was 100%.

Discussion:

Prenatal sonographic findings suggestive of TOF may be summarized as follows: a large aortic root, which is the most common prenatal sonographic finding, a small pulmonary artery or stenosis of the right ventricular outflow tract, a ventricular septal defect in the outlet portion of the septum, an overriding aorta, which is best seen in the long-axis view, and right ventricular hypertrophy. Other findings such as hydrops fetalis or polyhydramnios may also be helpful especially in the case of dysplastic pulmonary valves. The demonstration of a normal aortic root would render the presence of TOF unlikely diagnosis of posterior fossa abnormalities.

Conclusion:

The tetralogy of fallot is the most common congenital cyanotic heart disease. The antenatal diagnosis can lead to look for other associated abnormalities or chromosomal aberrations and allows us to determine a therapeutic strategy.