title: First trimester fetal echocardiography: which planes and defects can be displayed during the daily routine in a prenatal medicine unit?
abstract: OBJECTIVE
  The objective of this study was to evaluate which cardiac planes and malformations can be visualized by first trimester fetal echocardiography during the daily routine in a prenatal medicine unit.
  
  
  METHODS
  From October 2007 to June 2009, all fetuses with a crown rump length between 45 and 84 mm were included in the study. The fetal echocardiographies were carried out by one examiner. The entire examination including fetal echocardiography was completed within a time interval of 30 minutes. When possible, the abdominal plane, 4-chamber view (CV), pulmonary veins, left ventricular outflow tract, 3-vessel view (3-VV) and the aortic arch were visualized by color Doppler and/or power Doppler sonography.
  
  
  RESULTS
  690 fetuses were enrolled in the retrospective study. The abdominal plane, 4-CV, pulmonary veins, left ventricular outflow tract, 3-VV and the aortic arch were visualized in 99 %, 96 %, 23 %, 97 %, 98 % and 72 % of cases, respectively. During the study interval, 17 cardiac malformations were diagnosed. Outcome data were obtained in 92 % of the normal fetuses. 5 cardiac anomalies were diagnosed beyond the first trimester.
  
  
  CONCLUSIONS
  The standard planes of fetal echocardiography can be displayed in the first trimester in the clinical routine. Pulmonary veins can be visualized in almost a quarter of the cases. First trimester congenital heart diseases are strongly associated with chromosomal abnormalities during the first trimester.
authors.affiliation: Zentrum für Endokrinologie, Kinderwunsch und Pränatale Medizin, amedes Hamburg, Germany. martin.krapp@amedes-group.com
authors.forename: M
authors.initials: M
authors.lastname: Krapp
authors.forename: A
authors.initials: A
authors.lastname: Ludwig
authors.forename: R
authors.initials: R
authors.lastname: Axt-Fliedner
authors.forename: P
authors.initials: P
authors.lastname: Kreiselmaier
mesh_terms: D000328:Adult; D002869:Chromosome Aberrations; D018568:Crown-Rump Length; D004452:Echocardiography / Q000379:methods*; D018618:Echocardiography, Doppler, Color / Q000379:methods; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods; D019160:Endosonography / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D048208:Nuchal Translucency Measurement / Q000379:methods; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*