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The Diagnostics of Fetal Heart Defects in the First and Early Second Trimester – Early Fetal Echocardiography
Ist Teil von
Geburtshilfe und Frauenheilkunde, 2013-12, Vol.73 (12), p.1209-1217
Ort / Verlag
Stuttgart · New York: Georg Thieme Verlag KG
Erscheinungsjahr
2013
Quelle
EZB Electronic Journals Library
Beschreibungen/Notizen
Abstract
Examinations of the fetal heart are increasingly being conducted as part of
first-trimester screening, either as a sole visualisation of the
four-chamber view or a visualisation of the four-chamber view and both
ventricular outflow tracts or as a segmental approach as part of complete
fetal echocardiography. Alongside anamnestic risks, markers for heart
defects that become apparent during a first-trimester screening, such as
thickened nuchal translucency, an abnormal blood flow velocity profile in
the ductus venosus and the presence of tricuspid valve regurgitation, are
indications for an early echocardiogram in this high-risk group. However,
heart defects most often occur in fetuses in a low-risk group who display
none of the markers mentioned. An increasing number of examiners are
therefore also conducting a fetal echocardiogram as part of the detailed
first-trimester screening of fetal organs. Up to 80 % of severe heart
defects can be diagnosed as early as the 12th and 13th weeks of gestation.
Apart from the examinerʼs experience and the best possible equipment,
prerequisites are a consistent visualisation of all cross-sections and
connections following a strict protocol, including transvaginal approach in
some cases, and, in very rare cases, during a repeat examination a few days
later. Nevertheless, primarily due to the intrauterine development of some
heart defects, a further echocardiographic examination should always be
carried out in the second trimester, when the detection rate is up to 10 %
higher.