Fetal & Neonatal Cardiology Program, Division of Cardiology, Department of Pediatrics, Stollery Children's Hospital, Edmonton, Alberta, Canada.
Women and Children's Health Research Institute, Cardiovascular Research Institute, University of Alberta, Edmonton, Alberta, Canada.
Birth Defects Res. 2019 May 1;111(8):370-379. doi: 10.1002/bdr2.1414. Epub 2018 Nov 14.
To explore the technical aspects and clinical utility of early fetal echocardiography and screening of the fetal heart in early pregnancy. Also, to document differences in cardiac structure and function which can be demonstrated in the late first/early second trimesters.
In addition to summarizing our own experiences of late first/early second trimester fetal echocardiography, we reviewed the literature to explore clinical indications for, technical aspects, safety, accuracy, strengths and weaknesses of early fetal echocardiography.
In the current era, an increasing number of fetuses are identified as being at risk of congenital heart disease from as early as the late first trimester. In experienced hands, early fetal echocardiography can pick up a high proportion of congenital heart disease with good reliability for the majority of lesions. Early fetal echocardiography is relatively poor at assessing pulmonary veins, the atrioventricular valves and lesions that typically occur later or progress during the course of pregnancy. There is increasing interest in widespread implementation of an early obstetric anomaly screen which includes an assessment of the fetal heart for all pregnancies. There are a variety of hemodynamic differences in the late first/early second trimester compared with later in pregnancy.
Early fetal echocardiography is has become an established tool for detection of congenital heart disease. It affords opportunities to learn about the true spectrum and progression of congenital heart disease in-utero. Operators should be mindful of safety issues, technical aspects and hemodynamic findings which differ when performing echocardiograms at this stage of pregnancy.
探讨早期胎儿超声心动图和早孕胎儿心脏筛查的技术方面和临床应用。记录在妊娠晚期/早期第二个三月可以显示的心脏结构和功能的差异。
除了总结我们自己在妊娠晚期/早期第二个三月胎儿超声心动图的经验外，我们还回顾了文献，以探讨早期胎儿超声心动图的临床适应证、技术方面、安全性、准确性、优缺点。
在当前时代，越来越多的胎儿在妊娠晚期早期就被认为有患先天性心脏病的风险。在有经验的手中，早期胎儿超声心动图可以检测到相当比例的先天性心脏病，对大多数病变具有良好的可靠性。早期胎儿超声心动图在评估肺静脉、房室瓣以及在妊娠后期发生或进展的病变方面相对较差。人们越来越感兴趣的是在广泛实施早期产科异常筛查中，包括对所有妊娠的胎儿心脏进行评估。与妊娠后期相比，妊娠晚期/早期第二个三月存在各种血流动力学差异。
早期胎儿超声心动图已成为检测先天性心脏病的一种既定工具。它为了解先天性心脏病在宫内的真实谱和进展提供了机会。操作人员在进行这个阶段的超声心动图时应注意安全问题、技术方面和血流动力学发现的差异。
