Journal of Ultrasound in Medicine, Vol 13, Issue 10 783-789, Copyright © 1994 by American Institute of Ultrasound in Medicine
Transvaginal echocardiographic examination of the fetal heart between 13 and 15 weeks' gestation in a low-risk population
R. Achiron, A. Weissman, Z. Rotstein, S. Lipitz, S. Mashiach and J. Hegesh
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
The object of our investigation was to evaluate the potential of
transvaginal echocardiography for a complete anatomic study of the fetal
heart, and for detection of congenital heart diseases in low-risk pregnant
patients between 13 and 15 weeks' gestation. High-frequency (6.5 MHz and
7.5 MHz) transvaginal probes were employed for fetal echocardiographic
assessment. Six hundred and sixty patients considered at low risk for
congenital heart disease underwent in utero ultrasonographic studies,
neonatal records, postnatal imaging studies, and pathologic examination.
The four-chamber view was obtained in 100% of the fetuses, while the
extended fetal heart examination was completed in 98%. Six fetuses with
cardiac defects were diagnosed during the study: three had major heart
defects (aortic atresia, tetralogy of Fallot, and persistent truncus
arteriosus), all detected at the early transvaginal scan; three cardiac
anomalies escaped our early diagnosis; two fetuses had a minor ventricular
septal defect diagnosed only postnatally; and one had multiple cardiac
rhabdomyoma diagnosed in the third trimester. Our results demonstrate that
between 13 and 15 weeks' gestation transvaginal echocardiographic
assessment of the fetal heart in the low-risk population is feasible.
Moreover, some severe anomalies may be detected at such an early
gestational age.
