Diagnosis of Congenital Heart Disease by Early and Second-Trimester Fetal Echocardiography

Volpe, P.; Robertis, V. De; Campobasso, G.; Tempesta, A.; Volpe, G.; Rembouskos, G.

doi:10.7863/jum.2012.31.4.563

Cited by 45 publications

(64 citation statements)

References 20 publications

(24 reference statements)

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“…Other studies have also looked at the usefulness of evaluation of the fetal heart early in gestation. [17][18][19] These studies demonstrated that early imaging of the fetal heart is technically feasible and can identify a wide spectrum of significant CHD; however, unlike our study, there was significant cardiac disease that was missed on the initial early evaluation. Of course, it is expected that not all CHD will be identified, though we believe that with increasing experience and fetal cardiac expertise, improvements in technology, and creation of universal guidelines for fetal cardiac imaging, detection rates and accuracy will continue to improve.…”

Section: Discussioncontrasting

confidence: 45%

Early fetal echocardiography: congenital heart disease detection and diagnostic accuracy in the hands of an experienced fetal cardiology program

2014

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Section: Discussioncontrasting

confidence: 45%

Early fetal echocardiography: congenital heart disease detection and diagnostic accuracy in the hands of an experienced fetal cardiology program

2014

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“…The technical limits of EFEC are CRL < 50 mm, an increase of maternal Body mass index (BMI), unfavorable fetal position and a possible progression of cardiac disease especially in outflow obstructions [12,13]. This means that the pregnant women should be informed about the limits of early screening and also recommended to have a further scan as from 18 weeks for a more complete diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Fetal cardiac ultrasound analysis performed between the 12th and 16th week of pregnancy (compared with the usual 18-22 weeks) is defined as Early Fetal Echocardiography (EFEC) [8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Reliability of Early Fetal Echocardiography for Congenital Heart Disease Detection: A Preliminary Experience and Outcome Analysis of 102 Fetuses to Demonstrate the Value of a Clinical Flow-Chart Designed for At-Risk Pregnancy Management

Ventriglia¹,

Caiaro²

2016

Pediat Therapeut

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Early fetal echocardiography (EFEC) is a fetal cardiac ultrasound analysis performed between the 12th and 16th week of pregnancy (compared with the usual 18-22 weeks). In the last 10 years, the introduction of "aneuploidy sonographic markers" in screening for cardiac defects has led to a shift from late second to end of the first trimester or beginning of the second trimester of pregnancy for specialist fetal echocardiography. In this prospective study, early obstetric screening was performed between January 2014 and October 2015, using "aneuploidy sonographic markers" following SIEOG Guidelines 2014. These parameters were then collected and strategically combined in an evaluation score to select the group of pregnancies for performing EFEC, in accordance with the American Society of Echocardiography guidelines for fetal Echocardiography. All second-level examinations were performed transabdominally using a 3D convex volumetric probe with frequency range of 4-8 MHz (Accuvix -Samsung). The outcome data included transabdominal fetal echocardiography from 18 weeks to term and after birth. Overall, 99 pregnant women in the first trimester underwent EFEC (95 singleton and 4 twin pregnancies). Specifically, 30 fetuses were evaluated for extra-cardiac anomalies evidenced by obstetric screening (30%), 25 for family history of congenital heart diseases (25%), 8 for family history of genetic-linked diseases (8%), 4 for heart diseases suspected by obstetric screening (4%) and 19 by normal screening (19%). Was detected 11 (10.7%) CHD, when EFEC detected CHD, were compared to those performed later in pregnancy (18 weeks GA-term), a high degree of diagnosis correspondence was evidenced. The higher sensitivity value of EFEC vs late-FE, in comparison with the post-natal value, coupled with the high EFEC specificity shown vs both the end points, enabled us to consider it as a really reliable diagnostic technology, at least in perienced hands. The introduction of a key combination of the more sensitive obstetric and cardiologic variables should facilitate the formulation of a possible flow-chart as a guide for CHD at-risk pregnancies.

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“…The prenatal screening for anatomical and functional congenital heart disease (CHD) by fetal ultrasound and echocardiography allows the early prenatal diagnosis and postnatal prognosis by allowing the planning of delivery, and in some cases, the administration of prenatal therapy [1]. A detailed assessment of cardiac function by echocardiography is routinely performed in fetuses with CHD, and, recently, in those without anatomical heart defects, because it can assist in prenatal management and predict the perinatal and cardiovascular risks in the long term.…”

Section: Introductionmentioning

confidence: 99%

Applicability and technical aspects of two-dimensional ultrasonography for assessment of fetal heart function

et al. 2017

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In recent years, fetal echocardiography has been used for the screening and diagnosis of anatomical heart defects and for the detailed study of fetal cardiac function. This method is characterized by its easy implementation and good reproducibility, allowing the diagnosis of myocardial dysfunction even in its subclinical phase. The functional assessment of the fetal heart should be routinely performed in fetuses with congenital heart disease and those without anatomical malformation. Several extra-cardiac conditions may alter fetal cardiac function, by increased placental resistance, volume overload or hyperdynamic circulation, compression, or maternal systemic disease with involvement of the fetal myocardium. This review addresses the main ultrasound techniques and various Doppler echocardiographic parameters available for the analysis of fetal heart function, and correlates them with clinical applicability. Various parameters available for the assessment of fetal myocardium, including those that evaluate atrial dynamics, can be used in this analysis and should be selected considering specific conditions.

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Diagnosis of Congenital Heart Disease by Early and Second-Trimester Fetal Echocardiography

Cited by 45 publications

References 20 publications

Early fetal echocardiography: congenital heart disease detection and diagnostic accuracy in the hands of an experienced fetal cardiology program

Early fetal echocardiography: congenital heart disease detection and diagnostic accuracy in the hands of an experienced fetal cardiology program

Reliability of Early Fetal Echocardiography for Congenital Heart Disease Detection: A Preliminary Experience and Outcome Analysis of 102 Fetuses to Demonstrate the Value of a Clinical Flow-Chart Designed for At-Risk Pregnancy Management

Applicability and technical aspects of two-dimensional ultrasonography for assessment of fetal heart function

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