Prenatal screening for cardiac anomalies: the value of routine addition of the aortic root to the four-chamber view.

OBJECTIVE

To determine whether the addition of the aortic-root view would detect more congenital cardiac anomalies than a standard four-chamber view alone.

METHODS

The study included fetuses of 14 weeks' gestation or more who were scanned in our unit during a 28-month period. Outcome information was obtained from postnatal echocardiograms and autopsies. Abnormal hearts were classified as to whether the four-chamber or aortic-root view was abnormal.

RESULTS

There were 5967 fetuses in whom a four-chamber view could be obtained. In 5111 of these, an aortic-root view could also be obtained. The four-chamber view detected 24 (47%) of the 51 fetuses with abnormal hearts. Adding the aortic-root view increased the sensitivity to 78%.

CONCLUSIONS

Visualization of the aortic root is a quick and easy means of evaluating the aortic outflow tract during routine scanning. Adding the aortic-root view to the standard four-chamber view will result in the detection of most cardiac anomalies prenatally.