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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:187-196 • 0278-4297

Detection Rate of Early Fetal Echocardiography and In Utero Development of Congenital Heart Defects

Jan Michael Smrcek, MD, PhD, Christoph Berg, MD, PhD, Annegret Geipel, MD, PhD, Rolf Fimmers, MD, Roland Axt-Fliedner, MD, PhD, Klaus Diedrich, MD, PhD and Ulrich Gembruch, MD, PhD

Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Lübeck, Germany (J.M.S., R.A.-F., 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 study was to evaluate the detection rate of early fetal echocardiography and the in utero development of congenital heart defects (CHD). Methods. Cases were selected from all singleton pregnancies between 1997 and 2003 in which detailed fetal 2-dimensional and color-coded Doppler echocardiography was performed in our prenatal unit between 11 weeks’ and 13 weeks 6 days’ gestation; 2165 cases with complete outcome parameters were analyzed. Results. During this study period, CHD were diagnosed in 46 fetuses. Between 11 and 13 weeks’ gestation, 29 CHD were diagnosed (11 weeks, 9 cases; 12 weeks, 8 cases; and 13 weeks, 12 cases); 9 CHD were found in the second trimester and 2 in the third trimester. The in utero detection rate of fetal echocardiography was 86.96% (n = 40). Six additional CHD (13.04%) were detected postnatally. The spectrum of detected CHD changed with advancing gestational age and was different from the postnatal detected heart defects. Conclusions. Early fetal echocardiography is feasible and allows the detection of most CHD. Congenital heart defects vary in appearance at different stages of pregnancy and may evolve in utero with advancing gestational age. Therefore, early fetal echocardiography should always be followed by echocardiography at mid gestation.

Key Words: congenital heart defects • fetal echocardiography • fetal heart • first trimester • prenatal diagnosis

Abbreviations: CHD, congenital heart defects • NT, nuchal translucency

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.