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Updated: Jul 16, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Changes in fetal cardiac geometry with gestation: implications for 3- and 4-dimensional fetal echocardiography
Jimmy Espinoza1, Francesca Gotsch, Juan Pedro Kusanovic
1Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland/Detroit, Michigan, USA.
Insights
Fetal cardiac geometry changes significantly during gestation. These findings suggest that current 3D fetal echocardiography algorithms may require adjustments for optimal visualization of fetal heart anatomy across different gestational ages.
Area of Science:
- Cardiology
- Fetal Medicine
- Medical Imaging
Background:
- Three- and 4-dimensional fetal echocardiography utilizes novel algorithms.
- Current algorithms assume constant spatial relationships within the fetal heart throughout gestation.
Purpose of the Study:
- To investigate changes in fetal cardiac geometry during gestation.
- To assess the validity of assumptions in current 3D fetal echocardiography algorithms.
Main Methods:
- Cross-sectional study of 85 healthy fetuses (12-41 weeks gestation).
- Analysis of 3D/4D fetal echocardiography volume datasets using specialized software.
- Measurement of angles between cardiac structures: ductal arch, thoracic aorta, aortic arch, left outflow tract, and main pulmonary artery.
Main Results:
- The angle between the ductal arch and fetal thoracic aorta decreased with gestational age (Spearman rho: -0.39, P < .001).
- Angles between the ductal arch and aortic arch, and the left outflow tract and short axis increased with gestational age (Spearman rho: 0.45 and 0.40, P < .001).
Conclusions:
- Fetal cardiac geometry undergoes significant changes as gestation progresses.
- Algorithms for 3D fetal echocardiography may need adaptation for optimal visualization before 26 weeks gestation.
Objective:
Three- and 4-dimensional fetal echocardiography can be performed using novel algorithms. However, these algorithms assume that the spatial relationships among cardiac chambers and great vessels are constant throughout gestation. The objective of this study was to determine whether changes in fetal cardiac geometry occur during gestation.
Methods:
A cross-sectional study was conducted by reviewing 3- and 4-dimensional volume data sets from healthy fetuses obtained between 12 and 41 weeks of gestation. Volume data sets were examined using commercially available software. Parameters measured included angles between: (1) the ductal arch and fetal thoracic aorta; (2) the ductal arch and aortic arch; and (3) the left outflow tract and main pulmonary artery, as seen in the short axis of the heart. The mean angle from the left outflow tract to the short axis was calculated. Nonparametric statistics were used for analysis.
Results:
Eighty-five fetuses were included in the study. The angle between the ductal arch and the fetal thoracic aorta decreased with gestational age (Spearman rho coefficient: -0.39; P < .001). In contrast, the angle between the ductal arch and aortic arch, and the mean angle between the left outflow tract and the short axis of the heart increased with gestational age (Spearman rho coefficients: 0.45 and 0.40, respectively; P < .001).
Conclusions:
(1) Changes in fetal cardiac geometry were shown with advancing gestational age. (2) Proposed algorithms for the examination of the fetal heart with 3-dimensional ultrasonography may need to be adapted to optimize visualization of the standard planes before 26 weeks of gestation.
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