WS06‐06A novel sonographic approach to the fetal echocardiogram

Abstract

At present there are four concepts guiding the sonographic examination of the fetal heart: (1) the fetal echocardiogram (FEC) is difficult to perform and time‐consuming, (2) FEC should be performed only in high risk pregnancies, (3) the optimal time to perform FEC is 18–22 weeks gestation, (4) FEC relies on several sonographic still views. In our lecture, we will present a new systemic ‘video’ approach to the great vessels and the four chambers in early pregnancy using transvaginal sonography.Transvaginal ultrasound examination of the cardiovascular system was performed in 36 323 consecutive fetuses using a dynamic ‘video’ multidirectional approach. Cardiovascular anomalies were detected in 173 fetuses giving an overall incidence of 1 in 210 pregnancies and 1 in 238 low‐risk pregnancies. Fifty‐six percent of the fetuses had associated anomalies. The prenatal diagnosis was confirmed in 90 cases. In 10 fetuses a different cardiac anomaly was observed. In four fetuses the cardiovascular anomaly was not detected in early pregnancy. In the remaining cases, postmortem examination was not performed. Early fetal heart examination is suggested in all pregnancies.ConclusionsFetal ECC should be performed: (a) transvaginally, (b) in early pregnancy (14–16 weeks), (c) in every pregnancy , (d) using the video multidirectional approach.