Early fetal echocardiography--a reliable prenatal diagnosis tool.
OBJECTIVE
This study was undertaken to evaluate the feasibility and to report the detection rate of cardiac anomalies with fetal echocardiography before 16 weeks' gestation.


METHODS
This is a retrospective and prospective study of 160 early fetal echocardiograms. The mean gestational age was 13.5 weeks' gestation (range 11-15+6). All women had a repeat echocardiogram at 18 weeks' gestation and pregnancy outcome was obtained.


RESULTS
In all cases, a cardiac 4-chamber view was obtained. The atrioventricular valves were accurately seen in 154 (96%) cases; the ascending aorta and main pulmonary artery were visualized in 152 cases (95%). Overall, a satisfactory cardiac examination was feasible in 152 of cases (95%). There were 20 cardiac defects in this cohort (12.5%), 14 showed abnormalities at the time of the early ultrasound, whereas 6 were reported as normal. The sensitivity of early fetal echocardiography in this high-risk population was 70%, specificity 98%, positive predictive value 87.5%, and negative predictive value 96%.


CONCLUSIONS
The fetal heart can be examined early in pregnancy and a significant proportion of major cardiac defects identified.
McAuliffe
Fionnuala M
FM
Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Canada.
Trines
Jean
J
Nield
Lynne E
LE
Chitayat
David
D
Jaeggi
Edgar
E
Hornberger
Lisa K
LK
D005240:Feasibility Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal