Fetal Cardiac Evaluation

Abstract

Four chamber view of fetal heart is the most important view in both fetal echocardiography as well as the standard second trimester anomaly scan. This view does not require specialized skills, it can be obtained in all fetal positions, at all gestational ages from 12 weeks to term. Also, this view identifies almost 60%-70% of cardiac anomalies that can be detected antenatally. This talk will discuss the technique of obtaining a good four chamber view, ascertaining the position and situs of fetal heart, its size, axis, normal sizes of all four chambers, the heart valves, their alignment and functioning and most important, the use of colour Doppler in fetal echocardioagraphy. The anomalies associated with abnormal sizes of each chamber as well as abnormal number of chambers, abnormalities of valves and the IVS (interventricular septum) will be discussed. It has been shown by many that a normal four chamber view does not always mean a normal fetal heart. There are anomalies such TOF, TGA etc which may be missed if one relies only on this view. This talk will further discuss the anomalies which are diagnosed if one goes beyond the four chamber view.