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Diagnostic accuracy and short-term implications of prenatally diagnosed vascular rings: a single center study

Journal of Perinatology volume 45, pages 487–494 (2025)Cite this article

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Abstract

Objective

To assess the diagnostic accuracy and postnatal outcomes of fetuses with a suspected vascular ring (VR).

Study design

Single-center retrospective study of patients with suspected VR by fetal echocardiography. Postnatal evaluation included echocardiography +/- cross-sectional imaging. Outcomes, including symptomatology and surgery, were recorded and compared between VR types.

Results

Of 68 suspected fetal VRs, 81% were confirmed postnatally. Concordance between fetal and postnatal anatomy was 76%. Five neonates required resuscitation unrelated to VR. Symptoms presented in 13 patients (median 45 days), independent of VR type. Surgical intervention was performed in 15 patients (median 99 days); 80% were symptomatic. At a median follow-up of 6 months, 4 patients were symptomatic including 3 postoperative.

Conclusions

Fetal echocardiography accurately identifies and characterizes VR anatomy in most instances. Specialized delivery planning in uncomplicated cases is unnecessary given absence of symptoms at birth. Fetal diagnosis may not indicate surgical disease, as symptoms do not occur in all and early surgery does not guarantee symptom resolution.

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Fig. 1: Representative fetal and postnatal imaging demonstrating the diagnosis of an isolated vascular ring.
Fig. 2
Fig. 3: Kaplan-Meier curve demonstrating freedom from symptoms in patients with a prenatally diagnosed isolated vascular ring.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

Thank you to all the team members in the Children’s National Prenatal Cardiology Program and Echocardiology Laboratory for their contributions to this study, especially Megan Barbosa.

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Authors and Affiliations

  1. Department of Pediatrics, Children’s National Hospital, Washington, DC, USA

    Nicolle M. Ceneri

  2. Division of Cardiology, Children’s National Hospital, Washington, DC, USA

    Michelle L. Udine, Leanne Buckels, Stephanie R. Lacey & Mary T. Donofrio

  3. Division of Cardiovascular Surgery, Children’s National Hospital, Washington, DC, USA

    Manan H. Desai

  4. Department of Anesthesiology and Surgery, Boston Children’s Hospital, Boston, MA, USA

    Steven J. Staffa

  5. Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, USA

    Wendy Ho & Mary T. Donofrio

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  1. Nicolle M. Ceneri
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  2. Michelle L. Udine
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  8. Mary T. Donofrio
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Contributions

NMC, MLU, MHD, SJS, SRL, MTD contributed to the conception and design of the study. NMC, MLU, WH, and LB performed data acquisition. NMC and SJS performed data analysis. NMC wrote the original manuscript draft. All authors revised, reviewed, and approved the final manuscript.

Corresponding author

Correspondence to Mary T. Donofrio.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was approved and conducted under the Children’s National Hospital Institutional Review Board (Pro00011202) with a waiver of individual consent and in accordance with the Declaration of Helsinki.

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Ceneri, N.M., Udine, M.L., Desai, M.H. et al. Diagnostic accuracy and short-term implications of prenatally diagnosed vascular rings: a single center study. J Perinatol 45, 487–494 (2025). https://doi.org/10.1038/s41372-025-02244-x

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