Some aspects of fetal echocardiogram: 12 years of experience.
Fetal echocardiogram is a reliable tool for prenatal diagnosis of congenital heart disease. It is an important adjunction to obstetrical ultrasonography in caring for women during pregnancy. With improvement in resolution of 2-D echo images as well as the addition of parameter software, fetal echocardiography has found ever-expanding applications in both the structural and functional assessment of the fetal cardiovascular system. From the author's 12 years experience in fetal echocardiogram, 1,000 fetal hearts were studied and 12 cases had congenital heart defects (CHD): 4 ventricular septal defects, 1 Ebstein's anomaly, 1 Tetralogy of cantrell, 1 single atrium and single ventricle, 1 Hypoplastic left heart syndrome, 2 abnormal tricuspid valve with tricuspid regurgitation, 1 calcification RV, LV and interventricular septum with hydrops fetalis. Three hydrops fetalis were of unknown cause. Fetal heart size was evaluated by comparing the heart area/size with the chest area/size. The ventricular dimension was assessed by M-mode and 2-D echo. The ventricular volume could be measured by 2-D echo with a special formula. Evaluation of ventricular function was important and could be evaluated by M-mode, 2-D echo and Tissue Doppler Image (TDI). Pulsed Doppler and Doppler Colour Flow Image gave more information about the hemodynamics. The assessment of the foramen ovale, ductus venous, ductus arteriosus arteries including the umbilical artery and vein were also important and would be abnormal if the fetal heart had ventricular dysfunction and congestive heart failure. The fetal echocardiographic findings will help the obstetrician for further investigation and/or treatment including termination of pregnancy. The author would like to recommend that fetal echocardiogram be performed in all pregnant women at 18-22 weeks of gestation. The incidence of CHD in low risk pregnancy is as significant a finding as in high-risk pregnancy.
Jamjureeruk
Vachara
V
Bangkok Heart Institute, Bangkok General Hospital, Bangkok 10320, Thailand.
D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal