Smrcek Jan Michael, Berg Christoph, Geipel Annegret, Fimmers Rolf, Diedrich Klaus, Gembruch Ulrich
Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany.
J Ultrasound Med. 2006 Feb;25(2):173-82; quiz 183-5. doi: 10.7863/jum.2006.25.2.173.
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.
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.
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.
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.
本前瞻性横断面研究的目的是收集123例正常单胎妊娠10至15周胎儿心脏和大血管生物测量的规范数据。此外，我们还研究了早期胎儿超声心动图的不同方法和最佳检查时间。
所询问的参数包括心脏总直径；心脏面积和周长；左右心室直径；胸部直径、周长和面积；主动脉和肺动脉干直径。分析四腔心切面、三血管切面、大动脉起源和交叉、主动脉弓、动脉导管、上下腔静脉和肺静脉的可视化情况，并计算经阴道超声检查（TVS）和经腹超声检查（TAS）的成功率。
10周时无法对胎儿心脏进行完整评估；总成功率从11周时的45%增加到12至14周时的90%，15周时为100%。在10至13周之间，TVS优于TAS。14周时，两种方法相似，15周时，TAS能够充分显示所有结构。线性回归分析显示，所询问的参数与孕周、头臀长和双顶径之间存在显著相关性（P <.05）。左右心室直径之比以及肺动脉干与主动脉直径之比是恒定的。
通过TVS或TAS或两者对早期胎儿心脏进行评估是合理可行的。我们的规范数据有助于了解胎儿心脏和大动脉的正常发育以及早期妊娠心脏缺陷的检测。
