title: Early fetal echocardiography: heart biometry and visualization of cardiac structures between 10 and 15 weeks' gestation.
abstract: OBJECTIVE
  The purpose of this prospective cross-sectional study was to compile normative data about biometry of the fetal heart and great vessels between 10 and 15 weeks in 123 normal singleton pregnancies. Additionally, we investigated the different methods and the optimal examination time of early fetal echocardiography.
  
  
  METHODS
  The interrogated parameters included total heart diameter; heart area and circumference; right and left ventricular diameter; diameter, circumference, and area of the thorax; and diameter of the aorta and pulmonary trunk. Visualization of the 4-chamber view, 3-vessel view, origin and crossover of the great arteries, aortic arch, ductus arteriosus, superior and inferior venae cavae, and pulmonary veins was analyzed, and the success rates by transvaginal sonography (TVS) and transabdominal sonography (TAS) were calculated.
  
  
  RESULTS
  Complete evaluation of the fetal heart was impossible at 10 weeks; the total success rate increased from 45% at 11 weeks to 90% between 12 and 14 weeks and 100% at 15 weeks. Between 10 and 13 weeks, TVS was superior to TAS. At 14 weeks, both methods were similar to each other, and at 15 weeks, TAS allowed adequate visualization of all structures. Linear regression analysis showed a significant correlation between the interrogated parameters and gestational age, crown-rump length, and biparietal diameter (P < .05). The ratio of right and left ventricular diameters and the ratio of pulmonary trunk and aortic diameters were constant.
  
  
  CONCLUSIONS
  Early fetal heart evaluation by TVS or TAS or both is reasonable and feasible. Our normative data could be helpful for understanding the normal development of the fetal heart and great arteries and for detection of cardiac defects in early pregnancy.
authors.affiliation: Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany. jan.smrcek@frauenklinik.uni-luebeck.de
authors.forename: Jan Michael
authors.initials: JM
authors.lastname: Smrcek
authors.forename: Christoph
authors.initials: C
authors.lastname: Berg
authors.forename: Annegret
authors.initials: A
authors.lastname: Geipel
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Klaus
authors.initials: K
authors.lastname: Diedrich
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gembruch
mesh_terms: D000328:Adult; D001699:Biometry; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004452:Echocardiography; D005260:Female; D005318:Fetal Heart / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal