Related Experiment Video
Updated: Oct 27, 2025
Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound 30/45MHZ System
Published on: May 5, 2018
Accuracy of the Standardized Early Fetal Heart Assessment in Excluding Major Congenital Heart Defects in High-Risk
Sifa Turan1, Mehmet Resit Asoglu1, Halis Ozdemir1
1Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Insights
Standardized early fetal heart assessment (EFHA) effectively screens for major congenital heart defects (CHDs) in high-risk pregnancies. This method demonstrates high accuracy and can potentially be extended to the general obstetric population.
Area of Science:
- Prenatal Diagnosis
- Fetal Cardiology
- Medical Ultrasound
Background:
- Major congenital heart defects (CHDs) pose a significant risk in high-risk pregnancies.
- Early identification of CHDs is crucial for timely intervention and improved outcomes.
- Standardized assessment protocols enhance the reliability of prenatal screening.
Purpose of the Study:
- To evaluate the efficacy of early fetal heart assessment (EFHA) in excluding major CHDs.
- To determine the negative predictive value of EFHA in high-risk pregnancies.
- To assess the feasibility of expanding EFHA to broader obstetric populations.
Main Methods:
- A retrospective study of high-risk pregnancies undergoing EFHA between 11-14 weeks of gestation.
- EFHA included standardized views: 4-chamber view, outflow tract relationship, and transverse arches.
- Risk factors for CHDs and ultrasound markers were documented; primary outcome was the negative predictive value of EFHA.
Main Results:
- EFHA was performed on 1055 fetuses, with 1024 included in the final analysis.
- The overall accuracy of EFHA in excluding major CHDs was 99.5%, with a sensitivity of 93.2% and specificity of 99.9%.
- The false negative rate was low at 0.4%, indicating high reliability.
Conclusions:
- Early fetal heart assessment (EFHA) is a feasible and effective screening tool for major CHDs in high-risk populations.
- The high accuracy suggests EFHA could be beneficial for screening in the general obstetric population.
- Standardized EFHA protocols contribute to reliable prenatal detection of fetal cardiac anomalies.
Objective:
To evaluate the ability of standardized early fetal heart assessment (EFHA) that includes the 4-chamber view, outflow tract relationship (OTR), and transverse arches views (TAV) of the great arteries in excluding major congenital heart defects (CHDs) in high-risk populations.
Methods:
This retrospective study included high-risk pregnancies for CHDs undergoing EFHA at 11-14 weeks of gestation. Risk factors for CHDs were diabetes mellitus, a family history of CHDs, a history of a CHD use of teratogenic medications, seizure disorder, assisted reproductive treatment-conceived pregnancy, presence of at least one of the ultrasound markers: enlarged nuchal translucency (>95th percentile), tricuspid regurgitation, and reversed a-wave in the ductus venosus, presence of an extracardiac or a suspected cardiac anomaly, a high-risk first trimester combined screen result, and multiple pregnancies. EFHA consisted of visualization of 4ChV, OTR, and TAV, with and without power Doppler ultrasound. The primary outcome was the negative predictive value of EFHA in excluding major CHDs.
Results:
EFHA was performed on 1055 fetuses. Of these, 1024 were used for the final analysis. Of these, 94.9% (n = 923) were singleton. The most common indication for EFHA was maternal DM (n = 231, 22.6%). The sensitivity, specificity, false positive, false negative, and accuracy of EFHA were 93.2%, 99.9%, 1.4%, 0.4%, and 99.5% (P < .0001), respectively, in entire included cases. The performance of EFHA was 88%, 99.9%, 1.4%, 0.4%, and 99.5% (P < .0001) respectively when the terminated cases were excluded.
Conclusion:
Early fetal heart assessment is feasible for screening for major CHDs in high-risk populations. This approach may be expanded to the general obstetric population.
