title: Fetal cardiac evaluation at 11-14 weeks by experienced obstetricians in a low-risk population.
abstract: OBJECTIVE
  The aim of this study was to evaluate the detection rate of congenital heart diseases (CHD) in a low-risk population by performing cardiac evaluation during the first-trimester screening for chromosomal abnormalities. In this context, the role of four-chamber view, tricuspid regurgitation and abnormal ductus venosus flow in the screening for cardiac anomalies in a low-risk population was also investigated.
  
  
  METHODS
  The cardiac examination was performed by obstetricians with extensive experience in first- and second-trimester ultrasound (US). Follow-up US evaluations during the second and third trimesters were offered to all patients. In case of abnormal findings during routine assessment, fetal echocardiography was performed by a fetal cardiologist.
  
  
  RESULTS
  Among the 4445 fetuses included in the study, 42 CHD were detected (39 diagnosed prenatally and 3 postnatally). In 27 cases, the fetal cardiologist confirmed the type of CHD diagnosed at US screening. In 1 case, the diagnosis was slightly different in the second trimester, and in 3 of the 26 correctly diagnosed in the first-trimester cases, the CHD developed and progressed in severity. A significant association of major CHD and US first-trimester markers was observed.
  
  
  CONCLUSIONS
  First-trimester assessment of the fetal heart is feasible in a low-risk population when performed by experienced obstetricians. However, although most types of CHD can be diagnosed early in pregnancy, some may become apparent later in gestation.
authors.affiliation: Fetal Medicine Unit, Di Venere and Sarcone Hospitals, Bari, Italy. paolo-volpe@libero.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Volpe
authors.forename: Passamonti
authors.initials: P
authors.lastname: Ubaldo
authors.forename: Nicola
authors.initials: N
authors.lastname: Volpe
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campobasso
authors.forename: Valentina
authors.initials: V
authors.lastname: De Robertis
authors.forename: Annalisa
authors.initials: A
authors.lastname: Tempesta
authors.forename: Grazia
authors.initials: G
authors.lastname: Volpe
authors.forename: Georgios
authors.initials: G
authors.lastname: Rembouskos
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D002869:Chromosome Aberrations; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005318:Fetal Heart / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D009774:Obstetrics / Q000379:methods*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
chemical_list: D006063:Chorionic Gonadotropin; D011266:Pregnancy-Associated Plasma Protein-A