First trimester fetal echocardiography limitations and its expected clinical values

Area of Science:

• Perinatology
• Fetal Cardiology
• Medical Imaging

Background:

• Fetal cardiac activity is detectable from 6-7 weeks gestation.
• Early fetal echocardiography can screen for fetal heart disease.
• Effectiveness of early first-trimester fetal echocardiography with modern technology needs investigation.

Purpose of the Study:

• Evaluate visualization of fetal cardiac structures from 10 weeks gestation.
• Assess the value of color Doppler in early fetal echocardiography.

Main Methods:

• Prospective clinical trial of 150 subjects (44 twins).
• Weekly fetal echocardiographic examinations from 10 to 13 weeks gestation.
• Utilized 2D and color Doppler imaging.

Main Results:

• Four-chamber view visualized from 12 weeks; cardiac axis from 12 weeks.
• Inferior Vena Cava (IVC) visualized by 2D in 78.26% and color Doppler in 82.61% at 13 weeks.
• Ventricular inflows visualized from 10 weeks; pulmonary veins by 2D in 21.74% and color Doppler in 43.5% at 13 weeks.

Conclusions:

• First-trimester fetal echocardiography enhances management of potential fetal cardiac abnormalities.
• Enables early detection of structural cardiac anomalies.
• Facilitates further scanning for extracardiac anomalies and informs management decisions.