Imaginea de 3 vase şi trahee – marker important în anomaliile de vase mari

Abstract

Congenital heart malformations are the most common cause of fetal and infant mortality, with an incidence of 4-13 per 1000 live births. Antenatal ultrasound evaluation of the fetal heart has developed over the past 30 years, and has allowed the detection of many abnormalities in the first trimester of pregnancy. Prenatal screening for fetal mal­for­ma­tions is mandatory, allowing a better preg­nan­cy coun­­se­ling and greatly improving the neonatal prog­no­sis. According to the Romanian Society of Obstetrics and Gynecology (SOGR), the evaluation of the fetal heart start­ing from the first trimester of pregnancy is mandatory. Due to technological advances, the fetal heart can be as­ses­sed in detail as early as the first trimester, which al­lows for adequate counseling of the couple facing a mal­for­ma­tive heart pathology in their fetus, allows the ter­mi­na­tion of pregnancy at a legally optimal gestational age, or, when the ultrasound assessment does not reveal any fetal malformation, it assures the couple about the normal course of the pregnancy. The evaluation of the fetal heart using standard plans of examination is per­formed in each tri­mes­ter of pregnancy. We present a series of cardiac mal­for­ma­tions detected antenatally in our clinic, using stan­dard assessment views. The purpose of this study is to em­pha­size that most lesions involving the ejection tracts of the ar­te­ries at the base of the heart are associated with varying de­grees of disruption of the alignment, arrangement, size, or number of the three vessels, thus with an abnormal ap­­pea­rance of the stan­dard cross-section of three vessels. In all cases, the three-vessel view of the heart revealed an abnormal ap­pea­rance, helping us to diagnose major car­diac mal­for­ma­tions. This plan can be easily obtained in all tri­­mes­ters of pregnancy, providing sufficient information to de­tect many major conotruncal malformations.