Basic heart examination: feasibility study of first-trimester systematic simplified fetal echocardiography

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Cardiology

Background:

• Routine first-trimester ultrasound screening is standard for low-risk pregnancies.
• Comprehensive fetal echocardiography is typically reserved for high-risk cases.
• A need exists for a simplified cardiac screening in low-risk first-trimester pregnancies.

Purpose of the Study:

• To evaluate a simplified fetal echocardiographic ('basic heart') examination.
• To assess the feasibility of early detection of severe congenital heart defects in low-risk populations.
• To determine if a basic heart assessment can be integrated into routine first-trimester ultrasound.

Main Methods:

• A national 'flash study' conducted over two weeks during the first trimester.
• Sixty observers performed a simplified echocardiography on fetuses (CRL 45-84 mm).
• Targeted views included the four-chamber view (4CV) and three vessels and trachea (3VT) view, utilizing Doppler ultrasound.

Main Results:

• The four-chamber view (4CV) was successfully obtained and deemed normal in 86% of cases.
• The three vessels and trachea view (3VT) was successfully obtained and deemed normal in 79% of cases.
• Both views were successfully obtained and normal in 73% of the 597 examinations performed.

Conclusions:

• A simplified fetal echocardiography ('basic heart' examination) is feasible in low-risk first-trimester pregnancies.
• This basic examination can reassure parents or identify potential cardiac abnormalities for further investigation.
• The simplified approach allows for early identification of severe congenital heart defects.