Real-time 3-D echocardiographic evaluation of the fetal heart using instantaneous volume-rendered display.
OBJECTIVE
Using new real-time 3-D fetal echocardiography with instantaneous volume-rendered display, we evaluated the heart anatomy of a number of normal fetuses during pregnancy.


METHODS
Eighteen normal fetuses in 17 pregnancies (16 singletons and one twin) at 18-38 weeks' gestation were studied using a transabdominal real-time 3-D ultrasound machine. This machine proved capable of providing continuous 3-D sonographic images every 0.05 and 0.035 s without the need for an external workstation or other additional, costly equipment. For each patient, the fetal heart was first monitored using conventional 2-D echocardiography and was monitored again within 10 min using real-time 3-D echocardiography.


RESULTS
Consecutive real-time 3-D images showing a four-chamber view, long-axis view, short-axis view, and right ventricular outflow tract view were obtained in 100%, 66.6%, 38.8%, and 22.2% of fetuses in the study, respectively. Morphological changes to each atrium or ventricle could be observed clearly and in detail throughout the cardiac cycle. The opening and closing of each valve were clearly visible. Moreover, these observations could be made from any direction.


CONCLUSIONS
Real-time 3-D echocardiography provides a novel means for evaluation of the fetal heart in 3-D in real time in the second and third trimester of pregnancy. Real-time 3-D echocardiography may be an important modality in future fetal cardiac research and in evaluation of congenital heart disease in the fetus.
Hata
Toshiyuki
T
Department of Perinatology and Gynecology, Kagawa University School of Medicine, Kagawa, Japan. toshi28@med.kagawa-u.ac.jp
Kanenishi
Kenji
K
Tanaka
Hirokazu
H
Kimura
Kuniko
K
D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third