Detection of congenital heart defects throughout pregnancy; impact of first trimester ultrasound screening for cardiac abnormalities.
OBJECTIVE
To evaluate prospectively the efficacy to screen for congenital heart defects (CHD) during the first trimester nuchal translucency (NT) ultrasound examination by assessing the four chambers' view of fetal heart.


METHODS
Pregnancies that were examined prospectively by ultrasound in the first trimester (11th-14th week), the second (19th-24th week) and third trimester were included in the study. 3774 fetuses were examined and fetal heart was assessed during the NT scan by examining the four chambers view. Detailed echocardiography was performed during the anomaly and growth scans. Diagnosis of congenital heart defects (CHD) was further confirmed by a fetal cardiologist.


RESULTS
The four chambers view was obtained in 99.52% of the cases. CHD were diagnosed in 29 fetuses (0.77%). Thirteen cases (44.8%) were detected during the 11-13 weeks' scan, 14 cases (48.3%) during the anomaly scan, 1 CHD (3.5%) during the third trimester scan and 1 case (3.5%) postpartum.


CONCLUSIONS
Assessment of the four chambers of fetal heart early in pregnancy was feasible and allowed the detection of 45% of CHD. Additional parameters of fetal cardiac anatomy during the NT scan may further improve the detection rate providing pregnancy management information early in the first trimester.
Embryocare, Fetal Medicine Unit, Athens, Greece. makarios@hotmail.co.uk
Makarios
M
Eleftheriades
Elsa
E
Tsapakis
Alexandros
A
Sotiriadis
Emmanouil
E
Manolakos
Demetrios
D
Hassiakos
Demetrios
D
Botsis
D000025:Abortion, Eugenic / Q000706:statistics & numerical data; D000328:Adult; D042241:Early Diagnosis; D004526:Efficiency; D005260:Female; D005318:Fetal Heart / Q000002:abnormalities / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000145:classification / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007621:Karyotyping; D008403:Mass Screening / Q000379:methods; D048208:Nuchal Translucency Measurement / Q000379:methods; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016216:Ultrasonography, Prenatal / Q000379:methods