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Early evaluation of fetal heart anatomy: a prospective study from 6 to 10 weeks' gestation.

par Votino, Carmela ;Condorelli, Margherita ;Votino, R.;Bessieres, Bettina;Dessy, Hugues ;Cos Sanchez, Teresa
Référence 23rd World Congress on Ultrasound in Obstetrics and Gynecology(Sydney, Australia)
Publication Publié, 2013-10-01

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Résumé :

ObjectivesThe aim of the study is to evaluate the feasibility of an early cardiac examination and the sensibility in detecting congenital heart diseases between 6 and 10 weeks' gestation (WG).MethodsFrom October 2011 to January 2013, patients referred to our institution for an early scan before 11 WG were asked to participate to the study signing a written consent. A single fetal medicine specialist performed all the exams using alternatively a high frequency tranvaginal probe (6–12 MHz) or a conventional transvaginal probe (5–9 MHz) according to the distance between the probe and the fetal heart. The fetal heart anatomy has been assessed by the four chambers and great vessels views. Data were compared to the second trimester anomaly scan and autopsy.ResultsWe enrolled 733 patients and a total of 750 foetuses. Forty cases were excluded: 33 miscarriages, 3 molar pregnancies and 4 patients who refused a transvaginal scan. The 4 chambers view could be visualized in 51,4% of the cases between 6 and 8 WG, 90% of the cases between 8 and 10 WG and 97% between 10 and 11 WG. The greats vessels could be visualized in 49% of the cases before 9 WG, in 79,7% of the cases between 9 and 10 WG and in 94% of the cases between 10 and 11 WG. Seventy‐five cases were lost to the follow‐up after a normal first trimester scan. In 378 out of 635 cases, cardiac anatomy (4 chambers and great vessels) was considered normal and it was confirmed by a second trimester scan. In 7 out of 625 cases, a fetal heart abnormality was suspected. Later investigations confirmed the presence of a cardiac abnormality in 3 cases: an ectopia cordis in a Cantrell syndrome, a hypolastic left ventricle, and an atrio‐ventricular septal defect. In the remaining 4 cases, no cardiac abnormality was found.ConclusionsCardiac anatomy can be assessed very early in pregnancy, with a high sensibility in detecting congenital heart diseases and a high negative predictive value.