Screening for congenital heart disease with the four-chamber view of the fetal heart

AbstractThe sequential segmental approach is now universally used in the diagnosis of congenital heart disease. Its utilization during fetal sonography has not been well described. In this review, we show how the fetal heart can be approached in a sequential segmental manner by using six basic sonographic views. The transverse view of the fetal upper abdomen is obtained to determine the arrangement of the abdominal organs, which, in most cases, provides the important clues to the determination of the atrial arrangement. The four-chamber view is obtained to evaluate the atrioventricular junctions. The views of the left and right ventricular outflow tracts are obtained to evaluate the ventriculoarterial junctions. The three-vessel view and the aortic arch view are obtained for the evaluation of the arrangement and size of the great arteries, which provides the additional clues to the diagnosis of the abnormalities involving the ventriculoarterial junctions and the great arteries. The standard protocol to acquire these six basic views is also introduced.

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Dynamic fetal cardiac magnetic resonance imaging in four‐chamber view using Doppler ultrasound gating in normal fetal heart and in congenital heart disease: comparison with fetal echocardiography

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.20167 ◽

2019 ◽

Vol 53 (5) ◽

pp. 669-675 ◽

Cited By ~ 6

Author(s):

M. Tavares de Sousa ◽

K. Hecher ◽

J. Yamamura ◽

F. Kording ◽

C. Ruprecht ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Congenital Heart Disease ◽

Heart Disease ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Congenital Heart ◽

Fetal Heart ◽

Fetal Echocardiography ◽

Resonance Imaging ◽

Chamber View

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Magnetic resonance imaging in the normal fetal heart and in congenital heart disease

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.10061 ◽

2012 ◽

Vol 39 (3) ◽

pp. 322-329 ◽

Cited By ~ 26

Author(s):

C. Votino ◽

J. Jani ◽

N. Damry ◽

H. Dessy ◽

X. Kang ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Congenital Heart Disease ◽

Heart Disease ◽

Magnetic Resonance ◽

Congenital Heart ◽

Fetal Heart ◽

Resonance Imaging

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Magnetic resonance imaging in the normal fetal heart and in congenital heart disease

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/j.yobg.2012.06.052 ◽

2012 ◽

Vol 2012 ◽

pp. 31-32

Author(s):

L.P. Shulman

Keyword(s):

Magnetic Resonance Imaging ◽

Congenital Heart Disease ◽

Heart Disease ◽

Magnetic Resonance ◽

Congenital Heart ◽

Fetal Heart ◽

Resonance Imaging

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Sonographer-Identified Barriers and Facilitators to Prenatal Screening for Congenital Heart Disease

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479316677019 ◽

2016 ◽

Vol 33 (1) ◽

pp. 3-12 ◽

Cited By ~ 1

Author(s):

Nelangi Pinto ◽

Xiaoming Sheng ◽

Heather T. Keenan ◽

Janice L. B. Byrne ◽

Belva Stanton ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Self Efficacy ◽

Congenital Heart ◽

Fetal Heart ◽

Random Effect ◽

Image Interpretation ◽

Ultrasound Screening ◽

Fetal Ultrasound ◽

Detection Rates

Background: Fetal ultrasound screening for congenital heart disease has high detection rates in efficacy studies but not in practice. We investigated sonographers’ perspectives on barriers to screening and their association with intermediate measures of cardiac imaging. Methods: Barriers to fetal heart screening were identified in focus groups with obstetric sonographers. A web-based survey measured reported barriers and sonographers’ ability to interpret fetal heart screening images. Generalized linear random effect models assessed associations between barriers and image interpretation. Results: Four themes were identified: intrinsic barriers (self-efficacy), external barriers (time), informational needs, and provider and patient expectations. Among 224 sonographers surveyed, an average of 77.6% of fetal heart images were interpreted correctly. Perceptions about self-efficacy ( P = .03) and ease of performing imaging ( P = .01) were associated with accuracy of image interpretation. Conclusions: Several sonographer-identified barriers associated with image interpretation may be novel targets for improving prenatal detection of congenital heart disease.

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Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0038-1676058 ◽

2018 ◽

Vol 41 (01) ◽

pp. 011-016 ◽

Cited By ~ 1

Author(s):

Diesa Pinheiro ◽

Bruna Varisco ◽

Marcelo Silva ◽

Rafaela Duarte ◽

Graciele Deliberali ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Fetal Heart ◽

Heart Diseases ◽

Fetal Echocardiography ◽

Congenital Heart Diseases ◽

Obstetric Ultrasound ◽

Morphological Evaluation

Abstract Objective To evaluate the accuracy of the diagnosis of fetal heart diseases obtained through ultrasound examinations performed during the prenatal period compared with the postnatal evaluation. Methods A retrospective cohort study with 96 pregnant women who were attended at the Echocardiography Service and whose deliveries occurred at the Complexo Hospitalar Santa Casa de Porto Alegre, in the state of Rio Grande do Sul, Brazil. Risk factor assessment plus sensitivity and specificity analysis were used, comparing the accuracy of the screening for congenital heart disease by means of obstetrical ultrasound and morphological evaluation and fetal echocardiography, considering p < 0.05 as significant. The present study was approved by the Research Ethics Committee of the Institution. Results The analysis of risk factors shows that 31.3% of the fetuses with congenital heart disease could be identified by anamnesis. The antepartum echocardiography demonstrated a sensitivity of 97.7%, a specificity of 88.9%, and accuracy of 93% in the diagnosis of congenital heart disease. A sensitivity of 29.3% was found for the obstetric ultrasound, of 54.3% for the morphological ultrasound, and of 97.7% for the fetal echocardiography. The fetal echocardiography detected fetal heart disease in 67.7% of the cases, the morphological ultrasound in 16.7%, and the obstetric ultrasound in 11.5% of the cases. Conclusion There is a high proportion of congenital heart disease in pregnancies with no risk factors for this outcome. Faced with the disappointing results of obstetric ultrasound for the detection of congenital heart diseases and the current unfeasibility of universal screening of congenital heart diseases through fetal echocardiography, the importance of the fetal morphological ultrasound and its performance by qualified professionals is reinforced for a more appropriate management of these pregnancies.

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