Acoustic Output Measured by Thermal and Mechanical Indices during Fetal Echocardiography at the Time of the First Trimester Scan

Nemescu, Dragoş; Berescu, Anca

doi:10.1016/j.ultrasmedbio.2014.08.010

Cited by 18 publications

(22 citation statements)

References 25 publications

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“…However, it is recommended that mechanical indices should be taken into consideration. In our experience, and that of others, during early fetal echocardiography, these indices are well below recommended levels during fetal echocardiography in the first trimester (Hutchinson et al, 2017;Nemescu & Berescu, 2015;Nemescu & Onofriescu, 2015). Nonetheless, operators should be mindful of the potential risks and follow the ALARA principle-to keep fetal exposure to ultrasound As Low As Reasonably Achievable (Salvesen et al, 2011).…”

Section: The Safety Of Early Fetal Echocardiographymentioning

confidence: 53%

Early fetal echocardiography

McBrien

Hornberger

2018

Birth Defects Research

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Objectives To explore the technical aspects and clinical utility of early fetal echocardiography and screening of the fetal heart in early pregnancy. Also, to document differences in cardiac structure and function which can be demonstrated in the late first/early second trimesters. Methods In addition to summarizing our own experiences of late first/early second trimester fetal echocardiography, we reviewed the literature to explore clinical indications for, technical aspects, safety, accuracy, strengths and weaknesses of early fetal echocardiography. Results In the current era, an increasing number of fetuses are identified as being at risk of congenital heart disease from as early as the late first trimester. In experienced hands, early fetal echocardiography can pick up a high proportion of congenital heart disease with good reliability for the majority of lesions. Early fetal echocardiography is relatively poor at assessing pulmonary veins, the atrioventricular valves and lesions that typically occur later or progress during the course of pregnancy. There is increasing interest in widespread implementation of an early obstetric anomaly screen which includes an assessment of the fetal heart for all pregnancies. There are a variety of hemodynamic differences in the late first/early second trimester compared with later in pregnancy. Conclusion Early fetal echocardiography is has become an established tool for detection of congenital heart disease. It affords opportunities to learn about the true spectrum and progression of congenital heart disease in‐utero. Operators should be mindful of safety issues, technical aspects and hemodynamic findings which differ when performing echocardiograms at this stage of pregnancy.

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Section: The Safety Of Early Fetal Echocardiographymentioning

confidence: 53%

Early fetal echocardiography

McBrien

Hornberger

2018

Birth Defects Research

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“…Hutchinson and co-researchers verified the fact that to obtain a high rate of success for fetal anatomic cardiac evaluation, early fetal echo must be conducted after 11 gestational weeks [9]. On the other hand, in a smaller percentage of gestations, cardiac sonographic evaluation could be possible from 10th gestational week as sonographic researchers were in harmony with the current research study findings which have revealed that the real challenge is in the pulmonary vein evaluation in early fetal echocardiographic performance, with less than 50% successfully assessed by color Doppler even at 13 gestational weeks [10,12]. Developmental changes in the morphology and function of the early heart need to be considered in early fetal echocardiographic performance.…”

Section: Discussionmentioning

confidence: 50%

First trimester fetal echocardiography limitations and its expected clinical values

Kamel

Yehia

2020

Egypt Heart J

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Background: Fetal cardiac activity could be observed between 6th and 7th gestational weeks, early performance of fetal echocardiography could be implemented to screen for fetal heart disease. The effectiveness of early first trimester fetal echocardiography has not been adequately investigated, especially with modern sonographic technological advances. The purpose of the study is to evaluate the capability to visualize fetal cardiac structures within the first trimester as early as 10th gestational weeks and to elucidate the value of using color Doppler in visualization of cardiac structures within early gestation. A prospective clinical trial conducted on 150 study subjects, 44 of them were twin gestations. Cases were fully assessed by fetal echocardiographic examination from 10th gestational week to 13 gestational weeks in a sequential manner weekly. The research study was conducted at cardiology department fetal unit in one of the tertiary hospitals. Results: Four chamber view was mostly visualized from 12 gestational weeks, whereas cardiac axis was fully visualized in all cases from 12 gestational weeks; on the other hand, IVC assessment by 2D was satisfactorily visualized in 78.26% of cases and by color Doppler in 82.61% of cases at 13 gestational weeks, pulmonary veins were visualized in 21.74% of cases by 2D and 43.5% of cases by color Doppler at 13 gestational weeks, and interestingly, ventricular inflows were satisfactorily visualized in almost all cases from 10th gestational weeks. Conclusions: First trimester fetal echo is an outstanding enhancement in management pathways of cases susceptible to have fetal cardiac abnormalities permitting early detection of structural cardiac anomalies triggering a cascade of scanning for extra cardiac anomalies to aid in evaluation and assessment of the best management course for those affected cases. Publisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…Since recent studies showed that early pregnancy ultrasound evaluation is not dangerous to the embryo, there is no contraindication to perform early and first trimester ultrasound [3,4] as well as later in life [17]. Although it is expected that the majority of pregnant women had a first trimester ultrasound in our study only around 30% of them underwent this kind of examination.…”

Section: Accuracy Of Measurement Of Second Trimester Biochemical Markmentioning

confidence: 76%

“…The advantage of an integrated approach is that second trimester ultrasound evaluation allows the gathering of more fetal anatomical details compared to the first trimester ultrasound and these details could adjust the calculated risk [2]. Development of technology and of ultrasound machines in the last decade has reduced this gap and gives nowadays the possibility for an earlier fetal ultrasound evaluation [3,4]. The aim of the integrated screening test is to obtain fetal nuchal translucency (NT) and crown-rump length (CRL) values in the first trimester and to collect maternal serum in the second trimester.…”

mentioning

confidence: 99%

Is there a Need for Own Median Calculation in the Second Trimester Biochemical Markers Screening?

Navolan¹,

Nicolov²,

Vlădăreanu³

et al. 2017

Rev. Chim.

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Screening of fetal aneuploidies in early pregnancy is a well-established method in the materno-fetal medicine. The aim of our study was to analyze if the medians recommended by the manufacturers are adequate to perform an accurate screening or if there is a need for own laboratory medians calculation in second trimester biochemical marker screening.Sera were collected between 14 wp and 22 wp from 3374 singleton pregnancies. We analyzed three second trimester biochemical markers (AFP, hCG and free Estriol) concentration in all pregnant women and in a subgroup of pregnant women in which gestational age was determined based on crown-rump length. Our results showed that for all biochemical markers the difference between the manufacturer and the own calculated median was lower than 10% excepting the hCG value in the group of pregnant women in which the gestational age was determined on basis of crown-rump-length. Our results show it is recommended to replace the values of the median for hCG measurement with the own laboratory calculated medians. This does not seem to be necessary in the case of AFP and free Estriol measurement.

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Acoustic Output Measured by Thermal and Mechanical Indices during Fetal Echocardiography at the Time of the First Trimester Scan

Cited by 18 publications

References 25 publications

Early fetal echocardiography

Early fetal echocardiography

First trimester fetal echocardiography limitations and its expected clinical values

Is there a Need for Own Median Calculation in the Second Trimester Biochemical Markers Screening?

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