Anatomical and echocardiographic correlates of normal cardiac morphology in the late first trimester fetus.

Allan, Lindsey D.; Sousa-Santos, Ricardo; Pexieder, Tomáš

doi:10.1136/hrt.77.1.68

Cited by 57 publications

(36 citation statements)

References 14 publications

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“…This early detection enables, furthermore, the postulation of new theories on the pathogenesis of cardiac defects 77 . It is likely that in the near future new transducers will allow us to follow up the different stages of cardiac embryological development, but the safety of the method should first be evaluated 27,76,78 .…”

Section: Fetal Echocardiography and Cardiac Defectsmentioning

confidence: 99%

Fetal echo cardiography: the state of the art of the state of the heart

Chaoui¹

2001

Ultrasound in Obstet & Gyne

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Section: Fetal Echocardiography and Cardiac Defectsmentioning

confidence: 99%

Fetal echo cardiography: the state of the art of the state of the heart

Chaoui¹

2001

Ultrasound in Obstet & Gyne

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“…One of the important prerequisites in the application of fetal echocardiography is the establishment of normal cardiac growth curves. However, there are only few reports made before 16-20 weeks of gestation about normal morphology and diameters of the fetal heart and great arteries [4][5][6][7][8][9]. On the other hand detailed fetal cardiac measurements are available for 16-40 weeks of gestation [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Biometry of the Fetal Heart between 10 and 17 Weeks of Gestation

Gembruch

Shi

Smrcek³

2000

Fetal Diagn Ther

107

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Objectives: Assessment of the dimensions of the cardiac chambers and the great arteries in the human fetus may be helpful in the prenatal diagnosis of congenital heart disease. The purpose of this prospective cross-sectional study was to compile normative data in fetal cardiac measurements in early pregnancy. The structure of the fetal heart was examined in 136 normal singleton fetuses between 10 and 17 weeks of gestation. Methods: The transversal heart diameter, both ventricular dimensions, interventricular septal thickness, heart area, heart circumference, thoracic diameter, thoracic circumference and thoracic area were measured in the four-chamber view during diastole. Diameters of the pulmonary trunk and ascending aorta were obtained in the short axis and long axis view during systole. Ultrasound examinations were performed with a 5.0-MHz transvaginal and/or transabdominal phased-array sector scanner. Results: The four-chamber view and the cross-over of the pulmonary artery and the aorta were adequately visualized in 44% of the fetuses at 10 weeks of gestation, in 75% at 11 weeks of gestation, in 93% at 12 weeks of gestation and in 100% of the fetuses at 13–17 weeks of gestation. Before 14 weeks of gestation transvaginal sonography was superior to the transabdominal sonography in visualization of the fetal heart and great arteries. After 14 weeks of gestation transabdominal sonography accurately demonstrated the structure of the fetal heart. The ratio of right and left ventricle (RV/LV) and the ratio of the pulmonary trunk and aorta (PT/AO) were constant during this period of gestation (approximately 1.00 and 1.10, respectively). The ratio of the cardiac and thoracic area showed only a slight increase with advancing gestational age, but with significant correlation. The fetal heart rate showed a slow decrease from 167 to 150 bpm in this period of gestation. The transversal heart diameter, both ventricular dimensions, interventricular septal thickness, heart area, cardiothoracic diameter ratio, aortic diameter and the pulmonary trunk diameter showed a highly significant linear correlation to the gestational age and the biparietal diameter. Conclusion: The advancing quality of ultrasound images allows fetal echocardiography in the first and early second trimester. Our normative data could be the basis of studying the development of cardiac structures in congenital heart disease and it might be helpful in the detection of some congenital heart defects in early pregnancy.

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“…Allan et al [16] compared the echocardiographic characteristics of the cardiac morphology of human embryos and fetuses during the first trimester of gestation to the images of anatomical microdissection and demonstrated that the aorta and the pulmonary artery acquire approximately equal diameters starting from the 11th week of gestation.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the preference for the transvaginal over the transabdominal route is due to the high sound frequency emitted by these transducers ( 1 5 MHz) and by the reduction of the distance between the transducer and the fetal heart providing a better resolution and image definition [23] . The fetal heart can be examined after the 9th week of gestation by the transvaginal route [16] . However, it has been a general consensus that the best results are obtained after the 11th week [17,19,24] .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have demonstrated the importance of advances in the echocardiographic diagnosis of fetal congenital heart diseases in the first trimester, especially among high-risk pregnant women [12][13][14][15] . Although the indication of echocardiographic study of low-risk pregnant women is not a consensus among fetal medicine specialists, some studies have demonstrated the importance of establishing parameters of normality and criteria of cardiac evaluation during this phase [16][17][18][19] . Because of the technological and specialized human resources required for morphological fetal evaluation during the first trimester of pregnancy, this procedure is available only at some tertiary centers.…”

Section: Introductionmentioning

confidence: 99%

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First Trimester Fetal Echocardiography

Carvalho¹,

Mendes²,

Neto

et al. 2007

Gynecol Obstet Invest

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Objective: The aims of this study were to assess the feasibility of performing a complete fetal echocardiographic study during the first trimester of pregnancy, to establish the best week to accomplish a complete evaluation, and to find a relationship between the diameters of the cardiac valves and gestational age. Methods: 46 fetuses with normal nuchal translucency and venous duct Doppler velocimetry were submitted to echocardiographic studies by the transvaginal approach between the 11 + 0 and 14 + 6 weeks of gestation. A complete echocardiographic evaluation was defined as an examination in which the three basic planes, four-chamber, longitudinal and short-axis views, were obtained. Results: The rates of complete echocardiography evaluation were 37, 85 and 100% at 11, 12 and 13–14 weeks, respectively. The longitudinal view was the easiest to obtain and the short-axis view was the most difficult one. The diameter of the cardiac valves was compared with the crown-rump length (CRL) and there was no statistically significant difference between either the diameters of the mitral and tricuspid or the aortic and pulmonary valves. A linear growth curve was constructed to demonstrate the diameter correlations. Conclusions: The study demonstrated the feasibility of a complete fetal echocardiographic evaluation by the transvaginal approach during the first trimester of gestation. The rate of a complete evaluation increased along the period and reached100% when the CRL was 64 mm or 13 weeks of gestational age. There was a linear correlation between the cardiac valve diameters and the CRL revealing a relationship between the cardiac and fetal development. The absence of a statistically significant difference between the left and right valve dimensions possibly means that there is no predominance of right or left chambers during this period of evaluation.

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Anatomical and echocardiographic correlates of normal cardiac morphology in the late first trimester fetus.

Cited by 57 publications

References 14 publications

Fetal echo cardiography: the state of the art of the state of the heart

Fetal echo cardiography: the state of the art of the state of the heart

Biometry of the Fetal Heart between 10 and 17 Weeks of Gestation

First Trimester Fetal Echocardiography

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