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

Pike, Jodi I.; Krishnan, Anita; Donofrio, Mary T.

doi:10.1002/pd.4372

Cited by 30 publications

(29 citation statements)

References 22 publications

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“…Working with low-risk groups, welltrained operators can achieve a 40-50% detection rate of CHD, whereas for high-risk women, this detection can increase to >80% [89,90] .…”

Section: Discussionmentioning

confidence: 99%

Early Evaluation of the Fetal Heart

et al. 2017

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Evaluation of the fetal heart at 11-13 + 6 weeks of gestation is indicated for women with a family history of congenital heart defects (CHD), a previous child with CDH, or an ultrasound finding associated with cardiac anomalies. The accuracy for early detection of CHD is highly related to the experience of the operator. The 4-chamber view and outflow tracts are the most important planes for identification of an abnormal heart, and can be obtained in the majority of fetuses from 11 weeks of gestation onward. Transvaginal ultrasound is the preferred route for fetal cardiac examination prior to 12 weeks of gestation, whereas, after 12 weeks, the fetal heart can be reliably evaluated by transabdominal ultrasound. Cardiac defects, such as ventricular septal defects, tetralogy of Fallot, Ebstein's anomaly, or cardiac tumors, are unlikely to be identified at ≤14 weeks of gestation. Additional ultrasound techniques such as spatiotemporal image correlation and the evaluation of volumes by a fetal-heart expert can improve the detection of congenital heart disease. The evaluation of the fetal cardiac function at 11-13 + 6 weeks of gestation can be useful for early identification of fetuses at risk of anemia due to hemoglobinopathies, such as hemoglobin Bart's disease.

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“…Working with low-risk groups, welltrained operators can achieve a 40-50% detection rate of CHD, whereas for high-risk women, this detection can increase to >80% [89,90] .…”

Section: Discussionmentioning

confidence: 99%

Early Evaluation of the Fetal Heart

et al. 2017

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“…Dans le domaine de la cardiologie prénatale [19] le diagnostic formel est particulièrement délicat et chaque équipe a pu rencontrer des modifications de diagnostic lors de l'échographie réalisée après la naissance chez des enfants dont la mère avaient choisi les soins palliatifs à la naissance en alternative à l'IMG. Ces modifications ne remettent pas fondamentalement en cause le diagnostic anatomique mais le pronostic, lié à la fonction, peut devenir notoirement différent de ce qui émanait de l'échographie prénatale.…”

Section: L'incertitude Et Ses Fonctionsunclassified

La vie forcée ou corrigée en médecine périnatale : le point de vue du clinicien en néonatalogie

Bétrémieux¹

2015

Ethics, Medicine and Public Health

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“…Applying the systemic sequential approach, 2D, CD and Power Doppler (PW) were used to visualize and analyze the images and the flow signals obtained by four-chamber view with atrioventricular valve setting, right and left ventricle outflow tracts and crossing, aortic and ductal arches, sweep from four-chamber to three-vessel view, and to evaluate ventricular function and heart rhythm with mechanical PR interval [11]. First trimester classification of CHDs differs from the usual later and post-natal classification [10], when a complete diagnosis can be performed (Table 2).…”

Section: Citation: Ventriglia F Caiaro a Giancotti A Abed MM Ceccmentioning

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

Abstract: Objective Evaluate the utility of early fetal echocardiography in the hands of an experienced fetal cardiology program for detection of congenital heart disease (CHD) in high-risk pregnancies.

Cited by 30 publications

References 22 publications

Early Evaluation of the Fetal Heart

Early Evaluation of the Fetal Heart

La vie forcée ou corrigée en médecine périnatale : le point de vue du clinicien en néonatalogie

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

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