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First-Trimester Detection of Conotruncal Anomalies Using Transabdominal SlowflowHD: A Case Series and
Hirotsugu Fukuda1, Aya Fukuda1, Kazuya Mimura2
1Aya Fukuda Ladies Clinic, Hirotsugu Prenatal Diagnosis Center, Osaka, Japan.
Summary
SlowflowHD ultrasound improves early detection of conotruncal anomalies, such as tetralogy of Fallot, by enhancing visualization of fetal heart outflow tracts. This Doppler modality aids in identifying congenital heart defects during first-trimester screening.
Area of Science:
- Medical Imaging
- Fetal Cardiology
- Diagnostic Ultrasound
Background:
- First-trimester detection of conotruncal anomalies is challenging.
- SlowflowHD, a Doppler technique, offers enhanced sensitivity for low-flow states.
- Improved visualization of cardiac outflow tracts is crucial for early diagnosis.
Observation:
- A study evaluated transabdominal SlowflowHD in 1080 singleton pregnancies during the first trimester.
- Cardiac evaluation included grayscale, SlowflowHD (4CV, LVOT, 3VT), and HDlive™ Flow.
- Five fetuses with outflow tract anomalies (TOF, DORV, TGA) were identified.
Findings:
- SlowflowHD provided superior delineation of septo-aortic continuity and vessel alignment compared to grayscale imaging.
- All identified outflow tract anomalies were confirmed postnatally or in the second trimester.
- One case with trisomy 21 was detected and electively terminated.
Implications:
- SlowflowHD enhances the early detection of conotruncal anomalies.
- This modality can serve as a valuable adjunct to conventional first-trimester ultrasound screening.
- Further research in larger populations is recommended to validate these findings.
