Ultrasound of fetal cardiac anomalies

Fetal cardiac anomalies are common, with half of them being lethal or requiring complex surgeries. Early detection of these anomalies enables early referral to tertiary care centers with adequate expertise. A routine antenatal ultrasound performed between 18 and 22 weeks enables detection of most of these malformations. Further comprehensive evaluation can be performed with a dedicated fetal echocardiography, particularly in high-risk pregnancies and in cases with extracardiac anomalies.

Doppler imaging is used in the evaluation of vascular and valvular lesions. Three-dimensional imaging enables reconstruction of multiple complex planes from a single transverse acquisition. Four-dimensional imaging enables cine looping of images in multiple planes, enabling estimation of cardiac motion and function. This review illustrates the various sonographic techniques for evaluation of fetal hearts and the imaging appearance of various fetal cardiac anomalies.