Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 3 , ISSUE 3 ( July-September, 2009 ) > List of Articles

REVIEW ARTICLE

Early Fetal Echocardiography at the Time of 11+0–13+6 Weeks Scan

Agnieszka Nocun, Marcin Wiechec, Jill Beithon RT

Keywords : Early fetal echocardiography,early prenatal diagnosis,first trimester,congenital heart defects

Citation Information : Nocun A, Wiechec M, Beithon RT J. Early Fetal Echocardiography at the Time of 11+0–13+6 Weeks Scan. Donald School J Ultrasound Obstet Gynecol 2009; 3 (3):75-82.

DOI: 10.5005/jp-journals-10009-1023

License: CC BY-NC 4.0

Published Online: 01-09-2009

Copyright Statement:  Copyright © 2009; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Early Fetal Echocardiography (EFE) is generally defined as a fetal cardiac scan performed until 16 weeks of gestation. Fetal indications for EFE in the first trimester are in strong connection with ultrasound findings during routine nuchal scan: early diagnosed extracardiac malformations, abnormal ductus venosus (DV) velocimetry, tricuspid valve regurgitation (TR), single umbilical artery and increased NT measurement as a major fetal factor. Essential components of EFE include: abdominal view (AbdV), four chamber view (4CV), three vessel view (3VV), origin and cross-over of the great arteries (GA), aortic arch (AoA), ductal arch (DA), superior and inferior venae cavae and at least 2 pulmonary veins.

EFE has some limitations, which determine delayed diagnosis of some CHDs. Early fetal echocardiography is feasible and reasonable. It gives parents the opportunity to exclude approximately 60% of cardiac abnormalities and to reassure them of normal heart anatomy as early as possible.


PDF Share
  1. Fetal heart scanning in the first trimester. Prenat Diagn 2004;24:1060-67.
  2. Screening for Congenital Heart Disease: A Move towards Earlier Echocardiography. Am J Perinatol 2007;24:449-56.
  3. Detailed screening for fetal anomalies and cardiac defects at the 11-13 weeks scan. Ultrasound Obstet Gynecol 2006;27:613-18.
  4. Is measurement of nuchal translucency thickness a useful screening tool for heart defects? A study of 16 383 fetuses. Ultrasound Obstet Gynecol 2006;27:632-39.
  5. A routine ultrasound examination at 12 or 18 gestational weeks for prenatal detection of major congenital heart malformations? Randomized controlled trial comprising 36 299 fetuses. BJOG 2006;113:675-82.
  6. Detection Rate of Early Fetal Echocardiography and In Utero development of Congenital Heart Defects. J Ultrasound Med 2006;25:187-96.
  7. Arch Dis Child Fetal Neonatal Ed 2005;90:F374-F379.
  8. Prenat Diagn 2004;24:1116-22.
  9. Congenital Heart Defects. Natural Course and In Utero Development. Circulation 1997;96:550-55.
  10. Early Fetal Echocardiography. Heart biometry and visualization of cardiac structures between 10 and 15 week’ gestation. J Ultrasound Med 2006;25:173-83.
  11. Feasibility and accuracy of fetal echocardiography using four-dimensional spatiotemporal image correlation technology before 16 weeks’ gestation. Ultrasound Obstet Gynecol 2009;33:645-51.
  12. American Society of echocardiography guidelines and standards for Performance of the fetal echocardiogram J Am Soc Echocardiogr 2004;17:803-10.
  13. Ductus venosus Doppler in fetuses with cardiac defects and increased nuchal translucenct thickness. Ultrasound Obstet Gynecol 2008;31:256-60.
  14. Increased nuchal translucency and congenital hart defects in euploid fetuses. The Szeged experience. Eur J Obstet Gynecol Reprod Biol 2002;101:124-28.
  15. Nuchal translucency and fetal cardiac defects: A pooled analysis of major fetal echocardiography centers. Am J Obstst Gynecl 200; 192:89-95.
  16. Increased nucal translucency and congenital heart defects in a low-risk population. Prenat Diagn 2003;23:985-89.
  17. Using fetal nuchal translucency to screen for major congenital cardiac defects at 10-14 weeks of gestation: population based cohort study. BMJ 1999;318:81-84.
  18. The role of fetal nuchal translucency and ductus venosus Doppler at 11-14 weeks of gestation in the detection of major congenital heart defects. Ultrasound Obstet Gynecol 2003;21:239-43.
  19. Ductus venosus blood flow alterations in fetus with obstructive lesions of the right heart. Ultrasound Obstet Gynecol 2006;28:137-42.
  20. Fetal echocardiography at the time of nuchal translucency scan. Ultrasound Obstet Gynecol 2007;29:249-57.
  21. Am J Obstet Gynecol 2005;192:535-42.
  22. Fetal crownrump length: Re-evaluation of relation to menstrual age (5-18 weeks) with high-resolution real time US. Radiology 1992;182(2):501-05.
  23. Early fetal echocardiography heart biometry and visualization of cardiac structures between 10 and 15 weeks’ gestation JUM 2006;25:173-82.
  24. How successful is fetal echocardiography examination in the first trimester of pregnancy? Ultrasound Obstet Gynecol 2002;20:9-13.
  25. Prenat Diagn 2006;26:475-82.
  26. Early fetal echocardiography- A reliable prenatal diagnosis tool. Am J obset Gynecol 2005;193:1253-59.
  27. Fetal cardiac scanning performed immediately following an abnormal nuchal translucency examination. Prenat Diagn 2008;28:934-38.
  28. Fetal cardiac abnormalities identified prior to 14 weeks’ gestation. Ultrasound Obstet Gynecol 2002;20:22-29.
  29. First-Trimester Fetal Cardiac Function. J Ultrasound Med 2008;27:379-83.
  30. Fetal echocardiography at 11+0 to 13+6 weeks using four-dimensional spatiotemporal image correlation telemedicine via an Internet link: a pilot study Ultrasound Obstet Gynecol 2008;31:633-38.
  31. Standarization of the first-trimester fetal cardiac examination using spatiotemporal image correlation with tomographic ultrasound and color Doppler imaging. Ultrasound Obstet Gynecol 2009;33:652-56.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.