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Fetal heart scanning in the first trimester
1Brompton Fetal Cardiology, Royal Brompton Hospital and Fetal Medicine Unit, St. George's Hospital, London, UK. j.carvalho@rbh.nthames.nhs.uk
Prenatal Diagnosis
|December 23, 2004
Summary
First-trimester fetal echocardiography is a safe and accurate method for detecting major fetal heart defects. This early ultrasound screening can reassure families or identify abnormalities requiring further management.
Area of Science:
- Medical Imaging
- Fetal Medicine
- Cardiology
Background:
- Detailed fetal cardiac anatomy study in the first trimester is feasible and safe using ultrasound.
- Optimal imaging of fetal heart structures is achievable between 13-14 weeks gestation.
Purpose of the Study:
- To assess the feasibility and accuracy of first-trimester fetal echocardiography.
- To evaluate its role in identifying major structural cardiac abnormalities in early pregnancy.
Main Methods:
- Transvaginal and transabdominal ultrasound examinations.
- Focus on imaging four chambers and great arteries.
- Consideration of thermal and mechanical indices for safety.
Main Results:
- First-trimester fetal echocardiography is accurate in detecting major structural cardiac abnormalities.
- High negative predictive value for ruling out defects.
- Feasible and safe when safety indices are monitored.
Conclusions:
- Early fetal heart scanning can reassure 'at-risk' families or detect significant abnormalities.
- It should be integrated with comprehensive first-trimester obstetric scans.
- Associated chromosomal and extracardiac abnormalities must be considered.