First and early second trimester fetal heart screening.
OBJECTIVE
This review describes the recent advances in timing and effectiveness of first and early second trimester fetal echocardiography screening.


RESULTS
Fetal echocardiography can now be reliably performed from 11 weeks' gestation owing to improvements in ultrasound transducers and processors. Three-dimensional and four-dimensional ultrasound modalities in image acquisition and postprocessing analysis, including spatio-temporal image correlation, rendering three-dimensional power Doppler and high definition power flow Doppler, and B-flow have further improved our capabilities in this area. Fetal nuchal translucency measurement screening programs create a new population of at-risk pregnancies that will be referred for early fetal echocardiography. The majority of congenital heart defects, however, still occur in low-risk patients. Improved technology has lowered the gestational age at which fetal cardiac anatomy scanning can be reliably performed by properly trained and experienced examiners.


CONCLUSIONS
Early fetal echocardiography can be offered as a screening examination to at-risk and low-risk patients, with the proviso that it be repeated following screen-negative scans at mid-gestation to exclude later developing lesions.
Yagel
Simcha
S
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Jerusalem, Israel. simcha.yagel@gmail.com
Cohen
Sarah M
SM
Messing
Baruch
B
D019561:Echocardiography, Four-Dimensional; D005260:Female; D005318:Fetal Heart / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D016216:Ultrasonography, Prenatal / Q000379:methods*