title: Collaborative study of 4-dimensional fetal echocardiography in the first trimester of pregnancy.
abstract: OBJECTIVE
  Accumulating evidence supports a role for 2-dimensional fetal echocardiography in the first trimester of pregnancy for the identification of congenital heart defects. Our objective was to investigate the role of 4-dimensional (4D) sonography in the identification of congenital heart defects between 11 and 15 weeks of pregnancy.
  
  
  METHODS
  This study included 4 centers with expertise in first-trimester 4D fetal echocardiography. Fetuses with and without confirmed heart defects were evaluated between 11 and 15 weeks and their volume data sets were uploaded onto a centralized file transfer protocol server.
  
  
  RESULTS
  Forty-eight volume data sets from fetuses with normal (n = 17) and abnormal (n = 16) hearts were evaluated. Overall, the median (range) accuracy, sensitivity, and specificity, as well as the positive and negative likelihood ratios, for the identification of fetuses with congenital heart defects were 79% (77%-83%), 90% (70%-96%), 59% (58%-93%), 2.35 (2.05-9.80), and 0.18 (0.08-0.32), respectively.
  
  
  CONCLUSIONS
  (1) Four-dimensional fetal echocardiography can be performed in the first and early second trimesters of pregnancy; and (2) 4D volume data sets obtained from fetuses between 11 and 15 weeks can be remotely acquired and accurately interpreted by different centers.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.). jimmy.espinoza@bcm.edu.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Espinoza
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
authors.forename: Wesley
authors.initials: W
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
authors.forename: Fernando
authors.initials: F
authors.lastname: Viñals
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Martinez
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
authors.forename: Mar
authors.initials: M
authors.lastname: Bennasar
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rizzo
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, Texas USA (J.E., W.L., M.B.); Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA (J.E., W.L.); Centro AGB Ultrasonografía, Clínica Sanatorio Aleman, Concepción, Chile (F.V.); Department of Maternal-Fetal Medicine, Institut Clinic de Ginecologia, Obstetricia, i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain (J.M.M., M.B.); and Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy (G.R.).
authors.forename: Michael
authors.initials: M
authors.lastname: Belfort
mesh_terms: D003299:Cooperative Behavior; D019561:Echocardiography, Four-Dimensional / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology*; D006801:Humans; D007373:Interinstitutional Relations; D007558:Italy; D008297:Male; D015588:Observer Variation; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014481:United States
keywords: 4-dimensional sonography; congenital heart defects; echocardiography; fetal; first trimester; obstetric ultrasound; prenatal diagnosis, spatiotemporal image correlation