title: Fetal heart defects: potential and pitfalls of first-trimester detection.
abstract: Congenital heart defects (CHDs) are the leading cause of infant mortality due to birth defects. In the last 15 years, with the shift in screening for aneuploidies to the first trimester, extensive research has concentrated on early screening and detection of CHDs. Early detailed assessment of the fetal heart requires a high level of expertise in early anomaly scanning and fetal echocardiography. However, the detection of major CHDs at 11-13 weeks is influenced by their association with easily detectable markers, such as the nuchal translucency, ductus venosus blood flow and tricuspid regurgitation, and a policy decision as to the objectives of this scan and the allocation of resources necessary to achieve them. The use of transvaginal ultrasound and newer techniques are likely to improve the detection rate. However, the limitations of fetal echocardiography in the first trimester must be borne in mind, and follow-up at mid-gestational echocardiography is prudent in some cases.
authors.affiliation: Department of Fetal Medicine, St George's Hospital, University of London, UK.
authors.forename: Asma
authors.initials: A
authors.lastname: Khalil
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D005260:Female; D047109:Fetal Development; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000196:embryology; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D008297:Male; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016216:Ultrasonography, Prenatal / Q000639:trends
chemical_list: D015415:Biomarkers
keywords: Congenital heart defects; Ductus venosus; Echocardiography; Fetal; First trimester; Nuchal translucency; Tricuspid regurgitation