P45.06: Early fetal echocardiography with STIC technology

Abstract

The practice of Early Fetal Echocardiography (EFE) before 15 weeks of gestation has been reported for patients at high risk for congenital heart defects (CHD) such as familial history of CHD and NT measurement above the 99th centile. EFE is useful not only in diagnosing a specific CHD but also in the reassurance of normality at this stage of pregnancy. It is not always possible to have access to an experienced ultrasonographer for an early and midgestation echocardiography. The application of STIC technology could help to widespread EFE to those patients at risk for CHD. To determine the feasibility of EFE from 4D STIC volumes acquired by transvaginal approach at 11–14 weeks' gestation. Gray-scale and color-Doppler STIC volumes of 60 pregnant women were acquired from a 4-chamber view. The possibility of identification different cardiac planes was recorded. Only cases with a normal follow-up were included. Mean gestational age at volume acquisition: 13.2 (range 11.1–14.6) weeks. Mean time of volume evaluation: 10.31 (range 4.15–27.43) minutes. The analysis of the volumes was stratified by gestational age, showing that before 12 weeks of gestation only 50% of the volumes analyzed offered an appropriate cardiac examination. Volumes acquired from 12 to 14.6 weeks of gestation permitted an optimal cardiac examination in all cases, although there were three cases diagnosed of a interventricular communication that were not confirmed in the follow-up (false positives). EFE can be reliably performed from 4D STIC volumes acquired by transvaginal approach. A diagnosis of normality can be confidently done in high-risk pregnancies, though a further evaluation at 20–22 weeks' is recommended.