This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Smrcek, J. M. Articles by Gembruch, U. Search for Related Content PubMed PubMed Citation Articles by Smrcek, J. M. Articles by Gembruch, U.

Early Fetal Echocardiography

Heart Biometry and Visualization of Cardiac Structures Between 10 and 15 Weeks’ Gestation

Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Lübeck, Germany (J.M.S., K.D.); and Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology (C.B., A.G., U.G.), and Institute for Medical Biometry, Informatics, and Epidemiology (R.F.), University of Bonn, Bonn, Germany.

Address correspondence to Jan Michael Smrcek, MD, PhD, Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. E-mail: jan.smrcek{at}frauenklinik.uni-luebeck.de

Objective. The purpose of this prospective cross-sectional study was to compile normative data about biometry of the fetal heart and great vessels between 10 and 15 weeks in 123 normal singleton pregnancies. Additionally, we investigated the different methods and the optimal examination time of early fetal echocardiography. Methods. The interrogated parameters included total heart diameter; heart area and circumference; right and left ventricular diameter; diameter, circumference, and area of the thorax; and diameter of the aorta and pulmonary trunk. Visualization of the 4-chamber view, 3-vessel view, origin and crossover of the great arteries, aortic arch, ductus arteriosus, superior and inferior venae cavae, and pulmonary veins was analyzed, and the success rates by transvaginal sonography (TVS) and transabdominal sonography (TAS) were calculated. Results. Complete evaluation of the fetal heart was impossible at 10 weeks; the total success rate increased from 45% at 11 weeks to 90% between 12 and 14 weeks and 100% at 15 weeks. Between 10 and 13 weeks, TVS was superior to TAS. At 14 weeks, both methods were similar to each other, and at 15 weeks, TAS allowed adequate visualization of all structures. Linear regression analysis showed a significant correlation between the interrogated parameters and gestational age, crown-rump length, and biparietal diameter (P < .05). The ratio of right and left ventricular diameters and the ratio of pulmonary trunk and aortic diameters were constant. Conclusions. Early fetal heart evaluation by TVS or TAS or both is reasonable and feasible. Our normative data could be helpful for understanding the normal development of the fetal heart and great arteries and for detection of cardiac defects in early pregnancy.

Key Words: fetal echocardiography • fetal heart • fetal heart biometry • fetus • first trimester • prenatal diagnosis • transvaginal sonography

Abbreviations: AO, aortic diameter • BPD, biparietal diameter • CHD, congenital heart defects • CRL, crown-rump length • CTA, cardiothoracic area • CTD, cardiothoracic diameter • FHR, fetal heart rate • GA, gestational age • HA, heart area • HC, heart circumference • HD, heart diameter • LV, left ventricular diameter • PT, pulmonary trunk diameter • RV, right ventricular diameter • TAS, transabdominal sonography • TVS, transvaginal sonography