Ultrasound examination of pregnant women in diagnosing fetal cardiac pathology

2020 ◽  
Vol 69 (2) ◽  
pp. 43-50
Author(s):  
Viktoria A. Lim
Keyword(s):  
Pregnant Women ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Care Service ◽  
Ultrasound Screening ◽  
Atrioventricular Canal ◽  
Cardiac Pathology ◽  
Organ Systems ◽  
Atrioventricular Canal Defect

Hypothesis/aims of study. Fetal heart defects are the most common malformations causing infant mortality. The task of the obstetric care service is to make a timely diagnosis, which includes high-quality ultrasound screening and, if necessary, fetal echocardiography. This study aimed to compare fetal echocardiography with postpartum echocardiography. Study design, materials and methods. 101 pregnant women with both isolated fetal heart defects and combined pathology were examined for the period 20172019. Results. The greatest number of heart defects was detected at 2331 weeks of gestation. The structure of the malformations is diverse, the most common one being a complete form of the atrioventricular canal defect. In multiple pregnancies, complex heart defects were often combined with abnormalities in other organ systems. Conclusion. It is recommended to describe the heart structure in detail from 2122 weeks of pregnancy. If cardiac pathology is detected in utero, it is mandatory to conduct an examination of other fetal organs.

scholarly journals THE CLINICAL FEATURES OF ATRIOVENTRICULAR CANAL DEFECT

2017 ◽  
Vol 2 ◽  
pp. 14-21
Author(s):  
Andriana Malska
Keyword(s):  
Pulmonary Hypertension ◽  
Clinical Features ◽  
Clinical Manifestation ◽  
Congenital Heart ◽  
Viral Infections ◽  
Heart Defects ◽  
Mitral Valve Insufficiency ◽  
Atrioventricular Canal ◽  
Atrioventricular Canal Defect ◽  
Sternal Border

Atrioventricular canal defect (AVCD) is a congenital heart defect, which occurs in 2.9 % of all congenital heart defects (CHD) and is characterized by a wide variety of anatomical forms and often don’t have clear cardiac manifestation. Untreated AVCD may lead to the development of pulmonary hypertension. Aim. To determine clinical features of AVCD in children, considering variable anatomical forms of the pathology and its association with genetic pathology. Materials and methods. Patients history and outpatient statistic records of children with AVCD, who were admitted to Lviv Regional Children’s Hospital from September 1999 till January 2016 have been analyzed (n=84). The aspects of clinical manifestation of AVCD without associated pathology have been identified (n=48). Clinical manifestation of complete (n=36) and incomplete (n=12) AVCD and clinical manifestation with and without Down syndrome have been discussed. Children with AVCD were divided into two groups: A – children with complete (n=36) and B – with incomplete (n=12) form of AVCD. Group A was divided into A1 – with trisomy 21 (n=14), A2 – without genetic pathology (n=22). Results. In group А2 – 36,36±10,26 % and in group В – 50±14,4 % children were asymptomatic. Dyspnea, increased sweating during feeds, growth retardation and frequent respiratory viral infections during early childhood period were leading symptoms. Most frequent auscultation findings were accent of II heart sound over the pulmonary artery and 2-3/6 systolic murmur over left sternal border. According to echocardiographic examination mitral valve insufficiency was predominantly of mild grade, tricuspid insufficiency and pulmonary hypertension was diagnosed in group А2 with the frequency of 9,09±6,13 %). Conclusions: The absence of clinical features in group A2 and B 36,36±10,26 and 50,00±14,40 respectively, saturation levels 92,36±0,49 % in patients without genetic pathology and 95,25±0,40 % with incomplete AVCD provide a need to adopt protocol of children examination with saturation level under 95 % and compulsory echocardiographic diagnosis within the first month of life

Echocardiography in Early Pregnancy

2013 ◽  
Vol 7 (2) ◽  
pp. 168-181 ◽  
Author(s):  
Carmen Comas ◽  
Pilar Prats RodrRguez
Keyword(s):  
High Risk ◽  
Early Pregnancy ◽  
Fetal Heart ◽  
Early Stage ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Transvaginal Ultrasound ◽  
First Trimester ◽  
Slight Reduction

ABSTRACT Within the last decade, two significant events have contributed to the increasing interest in early fetal echocardiography. First, the introduction of high frequency vaginal ultrasound probes allows detailed visualization of cardiac structures at early stage of gestation, making early detection of fetal malformations possible. Second, the close relationship observed between some first trimester sonographic and Doppler markers and congenital heart defects allows an early identification of a high-risk group at 11 to 14 weeks of gestation. In this context, from the early 1990s, many authors have examined the potential role of the transvaginal approach to obtain earlier diagnosis of fetal cardiac malformations. Further studies have appeared in the literature showing that early transvaginal echocardiography in experienced hand is a fairly sensitive investigative tool. Although some malformations are detected as early as 11 weeks’ gestation, the optimal gestational age to perform the early scan is at least 13 weeks’ gestation. Transvaginal ultrasound is the preferred approach, although most of the authors agree that results can be improved if transabdominal ultrasound is also incorporated. The further application of color Doppler enhances visualization. The sensitivity and specificity of early fetal echocardiography for the detection of heart anomalies is acceptable compared to the ones obtained by mid-gestational echocardiography, showing a slight reduction in detection rates and an increase in false positive and negative rates. The cardiac anomalies detected at this early stage of pregnancy are mainly defects involving the four-chamber view, indicating that defects solely affecting the outflow tracts are difficult to diagnose in the first trimester of pregnancy. Heart defects diagnosed early in pregnancy tend to be more complex than those detected later, with a higher incidence of associated structural malformations, chromosomal abnormalities and spontaneous abortions. The neonate follow-up or postmortem examination in case of termination of pregnancy (TOP) is essential to assess the actual role of early fetal echocardiography. At present, early fetal echocardiography is a promising technique, which can be of considerable value for patients at high-risk. This technique is, however, currently limited to a few specialized centers. The aim of this review is to explore the possibilities of examining the fetal heart at this early stage of pregnancy. This article also present our experience in the first multicenter trial in early fetal echocardiography performed in Spain. In accordance with other studies, this experience stresses the usefulness of early echocardiography when performed by expert operators on fetus specifically at risk for cardiac defects. Our review of these additional 48 cases contributes to the expanding literature on the ability of transvaginal ultrasonography to detect fetal heart defects in early pregnancy. How to cite this article Gabriel CC, Rodriguez PP. Echocardiography in Early Pregnancy. Donald School J Ultrasound Obstet Gynecol 2013;7(2):168-181.

scholarly journals Convolutional neural network for semantic segmentation of fetal echocardiography based on four-chamber view

2021 ◽  
Vol 10 (4) ◽  
pp. 1987-1996
Author(s):  
M. N. Rachmatullah ◽  
Siti Nurmaini ◽  
A. I. Sapitri ◽  
A. Darmawahyuni ◽  
B. Tutuko ◽  
...  
Keyword(s):  
Septal Defect ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Semantic Segmentation ◽  
Ultrasound Images ◽  
Combination Technique ◽  
Manual Task ◽  
Chamber View ◽  
Testing Data

The acute shortage of trained and experienced sonographers causes the detection of congenital heart defects (CHDs) extremely difficult. In order to minimize this difficulty, an accurate fetal heart segmentation to the early location of such structural heart abnormalities prior to delivery is essential. However, the segmentation process is not an easy task due to the small size of the fetal heart structure. Moreover, the manual task for identifying the standard cardiac planes, primarily based on a four-chamber view, requires a well-trained clinician and experience. In this paper, a CNN method using U-Net architecture was proposed to automate fetal cardiac standard planes segmentation from ultrasound images. A total of 519 fetal cardiac images was obtained from three videos. All data is divided into training and testing data. The testing data consist of 106 slices of the four-chamber segmentation tasks, i.e. atrial septal defect (ASD), ventricular septal defect (VSD), and normal. The segmentation of the post-processing method is needed to enhanced the segmentation result. In this paper, a combination technique with U-Net and Otsu thresholding gives the best performances with 99.48%-pixel accuracy, 96.73% mean accuracy, 94.92% mean intersection over union, and 0.21% segmentation error. In the future, the implementation of Deep Learning in the study of CHDs holds significant potential for identifying novel CHDs in heterogeneous fetal hearts.

scholarly journals Early Fetal Echocardiography

2017 ◽  
Vol 11 (1) ◽  
pp. 29-43
Author(s):  
Pilar Prats ◽  
Carmina Comas
Keyword(s):  
High Risk ◽  
Fetal Heart ◽  
Early Stage ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Transvaginal Ultrasound ◽  
False Negative ◽  
First Trimester ◽  
Slight Reduction

ABSTRACT Within the last decade, two significant events have contributed to the increasing interest in early fetal echocardiography. First, the introduction of high-frequency vaginal ultrasound probes allows detailed visualization of cardiac structures at early stage of gestation, making early detection of fetal malformations possible. Second, the close relationship observed between some first trimester sonographic and Doppler markers and congenital heart defects allows an early identification of a high-risk group at 11 to 14 weeks of gestation. In this context, from the early 1990s, many authors have examined the potential role of the transvaginal (TV) approach to obtain earlier diagnosis of fetal cardiac malformations. Further studies have appeared in the literature showing that early TV echocardiography in experienced hands is a fairly sensitive investigative tool. Although some malformations are detected as early as 11 weeks gestation, the optimal gestational age to perform the early scan is at least 13 weeks gestation. Transvaginal ultrasound is the preferred approach, although most of the authors agree that results can be improved if transabdominal ultrasound is also incorporated. The further application of color Doppler enhances visualization. The sensitivity and specificity of early fetal echocardiography for the detection of heart anomalies is acceptable compared with the ones obtained by midgestational echocardiography, showing a slight reduction in detection rates and an increase in false-positive and false-negative rates. The cardiac anomalies detected at this early stage of pregnancy are mainly defects involving the four-chamber view, indicating that defects solely affecting the outflow tracts are difficult to diagnose in the first trimester of pregnancy. Heart defects diagnosed early in pregnancy tend to be more complex than those detected later, with a higher incidence of associated structural malformations, chromosomal abnormalities, and spontaneous abortions. The neonate follow-up or postmortem examination in case of termination of pregnancy is essential to assess the actual role of early fetal echocardiography. At present, early fetal echocardiography is a promising technique, which can be of considerable value for patients at high risk. This technique is, however, currently limited to a few specialized centers. The aim of this review is to explore the possibilities of examining the fetal heart at this early stage of pregnancy. This article also presents our experience in the first multicenter trial in early fetal echocardiography performed in Spain. In accordance with other studies, this experience stresses the usefulness of early echocardiography when performed by expert operators on fetus specifically at risk for cardiac defects. Our review of these additional 48 cases contributes to the expanding literature on the ability of TV ultrasonography to detect fetal heart defects in early pregnancy. How to cite this article Comas C, Prats P. Early Fetal Echocardiography. Donald School J Ultrasound Obstet Gynecol 2017;11(1):29-43.

A Rapid and Convenient Fetal Heart Screening Proposal Based on Dynamic Sequential Cross-Section

2019 ◽  
Vol 9 (6) ◽  
pp. 1083-1085
Author(s):  
Yi Zhou ◽  
Wenqian Qiu ◽  
Shuqing Jiang ◽  
Danqing He ◽  
Chaoxue Zhang
Keyword(s):  
Global Health ◽  
Cross Section ◽  
Congenital Heart ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Screening Method ◽  
Health Burden ◽  
Infant Morbidity ◽  
Section Analysis

Congenital heart defects (CHDs) are a global health burden and a leading cause of infant morbidity and mortality. Fetal echocardiography is currently the best method for diagnosing CHDs prenatally, but it is not yet widely used for all fetuses because it is a time-consuming process that requires a highly skilled sonographer. We propose a dynamic sequential cross-section analysis as a screening method for CHDs; this screening method can systematically evaluate the fetal heart effectively and quickly.

scholarly journals The Diagnostics of Fetal Heart Defects in the First and Early Second Trimester – Early Fetal Echocardiography

2013 ◽  
Vol 73 (12) ◽  
pp. 1209-1217 ◽  
Author(s):  
U. Gembruch ◽  
A. Kempe ◽  
A. Hellmund ◽  
B. Rösing ◽  
A. Willruth ◽  
...  
Keyword(s):  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Second Trimester

scholarly journals Applicability and technical aspects of two-dimensional ultrasonography for assessment of fetal heart function

2017 ◽  
Vol 19 (1) ◽  
pp. 94 ◽  
Author(s):  
Nathalie Jeanne Bravo-valenzuela ◽  
Alberto Borges Peixoto ◽  
Luciano Marcondes Nardozza ◽  
Alex Sandro Souza ◽  
Edward Araujo Júnior
Keyword(s):  
Cardiac Function ◽  
Fetal Heart ◽  
Heart Function ◽  
Fetal Echocardiography ◽  
Myocardial Dysfunction ◽  
Heart Defects ◽  
Systemic Disease ◽  
Volume Overload ◽  
Fetal Cardiac Function ◽  
Echocardiographic Parameters

In recent years, fetal echocardiography has been used for the screening and diagnosis of anatomical heart defects and for the detailed study of fetal cardiac function. This method is characterized by its easy implementation and good reproducibility, allowing the diagnosis of myocardial dysfunction even in its subclinical phase. The functional assessment of the fetal heart should be routinely performed in fetuses with congenital heart disease and those without anatomical malformation. Several extra-cardiac conditions may alter fetal cardiac function, by increased placental resistance, volume overload or hyperdynamic circulation, compression, or maternal systemic disease with involvement of the fetal myocardium. This review addresses the main ultrasound techniques and various Doppler echocardiographic parameters available for the analysis of fetal heart function, and correlates them with clinical applicability. Various parameters available for the assessment of fetal myocardium, including those that evaluate atrial dynamics, can be used in this analysis and should be selected considering specific conditions.

scholarly journals Deep Learning-Based Computer-Aided Fetal Echocardiography: Application to Heart Standard View Segmentation for Congenital Heart Defects Detection

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 8007
Author(s):  
Siti Nurmaini ◽  
Muhammad Naufal Rachmatullah ◽  
Ade Iriani Sapitri ◽  
Annisa Darmawahyuni ◽  
Bambang Tutuko ◽  
...  
Keyword(s):  
Deep Learning ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Disease Diagnosis ◽  
Detection Techniques ◽  
Accuracy Of Measurements ◽  
Computer Aided

Accurate segmentation of fetal heart in echocardiography images is essential for detecting the structural abnormalities such as congenital heart defects (CHDs). Due to the wide variations attributed to different factors, such as maternal obesity, abdominal scars, amniotic fluid volume, and great vessel connections, this process is still a challenging problem. CHDs detection with expertise in general are substandard; the accuracy of measurements remains highly dependent on humans’ training, skills, and experience. To make such a process automatic, this study proposes deep learning-based computer-aided fetal heart echocardiography examinations with an instance segmentation approach, which inherently segments the four standard heart views and detects the defect simultaneously. We conducted several experiments with 1149 fetal heart images for predicting 24 objects, including four shapes of fetal heart standard views, 17 objects of heart-chambers in each view, and three cases of congenital heart defect. The result showed that the proposed model performed satisfactory performance for standard views segmentation, with a 79.97% intersection over union and 89.70% Dice coefficient similarity. It also performed well in the CHDs detection, with mean average precision around 98.30% for intra-patient variation and 82.42% for inter-patient variation. We believe that automatic segmentation and detection techniques could make an important contribution toward improving congenital heart disease diagnosis rates.

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