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WS06‐07Examination of the fetal heart by five short‐axis views: The optimal screening method for fetal cardiac anomalies?
Author(s) -
Yagel S.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00009-1-41.x
Subject(s) - medicine , aortic arch , fetal heart , anatomy , transverse plane , ductus arteriosus , great vessels , arch , mediastinum , aorta , abdomen , fetus , radiology , cardiology , pregnancy , civil engineering , biology , engineering , genetics
‘Classic’ fetal echocardiography is based on 7 transverse planes: the upper abdomen, the traditional four‐chamber view, the five‐chamber view in which the aortic root is visualized, and the fourth transverse view revealing the bifurcation of the pulmonary arteries, and long‐axis views of the outflow tracts and aortic arch. We recently proposed the three vessel and trachea (3VT) plane of insonation be added, to facilitate and expedite fetal heart evaluation. The (3VT) is the most cephalad transverse view, visualized on a plane crossing the fetal upper mediastinum. It is obtained easily by moving the transducer cephalad and slightly oblique from the FCV, and shows the main pulmonary trunk (MPA) in direct communication with the ductus arteriosus (DA). A transverse section of the aortic arch is seen to the right of the MPA and DA. Cross sections of the superior vena cava (SVC), and posterior to it the trachea, are visualized. The clinical applicability of the 3VT was demonstrated in a recent study encompassing 1263 low‐and high‐risk cases scanned between 14 and 24 weeks' gestation. We consider one of the greatest advantages of our novel approach the ease with which the examiner can scan the fetal heart, beginning with the caudal upper‐abdomen view. By sliding the transducer cephalad in one continuous motion, all the pertinent views are readily visualized. It was also shown to be effective in the diagnosis of such aortic arch anomalies as right and double aortic arch, among others. We showed that five short axis views including the 3VT simplified and streamlined fetal cardiac examination, without compromising diagnostic effectiveness.