Abstract
To assess the quality of fetal heart views by three-dimensional/four-dimensional (3D/4D) ultrasonography using spatio-temporal image correlation (STIC) in the second and third trimester of pregnancy. This prospective and cross-sectional study was conducted at a single referral service for the screening of congenital heart diseases (CHDs), with pregnant women at 20-30weeks' gestation with a normal fetal heart. 3D/4D STIC were obtained from the fetal heart screening in the following views: four-chamber (4C), left and right ventricular outflow tracts (LVOT and RVOT), 3 vessels and trachea (3VT), aortic arch (AA), and ductal arch (DA). We categorized the images as satisfactory or unsatisfactory and performed McNemar's test to evaluate the differences between the two-dimensional (2D) echocardiography and 3D/4D STIC techniques. The inter-observer concordance was obtained by kappa coefficient. The rate of satisfactory fetal heart views using 3D/4D STIC was 54% by using 4 planes (4C, RVOT, LVOT, and 3VT) and 14% by using 6 planes (4C, RVOT, LVOT, 3VT, AA, and DA). In contrast, 100% of the 2D echocardiography images were satisfactory (McNemar's test, P<0.001). We observed moderate inter-observer concordance to both 4- and 6 planes (κ=0.56 and 0.43, respectively). The quality of the main fetal heart views by 3D/4D STIC still present some limitations compared with the 2D echocardiography.
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