The use of echocardiography in fetuses with ultrasound soft markers at first trimester

Abstract

Objective To investigate the value of fetal echocardiography in the diagnosis of congenital heart disease at first trimester in fetuses with ultrasound soft markers. Methods Early fetal echocardiography was performed in 133 fetuses with ultrasound soft markers. Special attention was paid at four-chamber view and three vessels and trachea view. Additional fetal echocardiographic planes were also obtained as much as possible. Follow-up was taken 2-4 weeks after cardiac abnormality was suspected. Based on the fingdings of follow-up echocardiography, autopsy was conducted for the fetuses with confirmed diagnosis. On the other hand, routine fetal echocardiography at second trimester and neonatal echocardiography after birth were performed for the fetuses without definite diagnosis. Results Four-chamber view and three vessels and trachea view were successfully achieved in 78% (104/133, 78%) and 77% (103/133, 77%) cases, respectively. Ten cases of congenital heart disease (CHD) were suspected by early fetal echocardiography. One case was lost at follow-up and the rest 9 cases were confirmed by autopsy. Among the 9 cases, 7 were diagnosed correctly and 2 were misdiagnosed. Additional 2 cases of CHD were detected during follow-up. The accuracy of early fetal echocardiography in the diagnosis of complex congenital heart disease was 63.6% (7/11, 63.6%). Conclusion Early fetal echocardiography is feasible and most complex CHDs can be detected at early stage of pregnancy. Key words: Echocardiography; Fetus; Congenital heart disease