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Four‐chamber view of the fetal heart: demonstration related to menstrual age.
Author(s) -
Shultz S M,
Pretorius D H,
Budorick N E
Publication year - 1994
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.1994.13.4.285
Subject(s) - medicine , gestational age , fetus , gestation , obstetrics , menstrual cycle , pregnancy , prospective cohort study , gynecology , surgery , genetics , hormone , biology
The four‐chamber view of the fetal heart is the most widely used screening examination for the detection of structural cardiac abnormalities during routine fetal ultrasonography. A prospective study of 520 consecutive routine fetal sonograms taken between 13 and 39 weeks of gestational age was performed to determine the frequency of obtaining a satisfactory four‐chamber view, focusing on fetuses of less than 19 weeks' menstrual age. Menstrual age was a significant variable in procuring a satisfactory four‐chamber view. Visualization of a normal four‐chamber view on film progressively increased from five out of 15 (33%) at 14 weeks of menstrual age to 35 out of 38 (92%) at 19 weeks of menstrual age; real‐time evaluation improved visualization to six out of 15 (40%) at 14 weeks of menstrual age and to 36 out of 38 (95%) at 19 weeks of menstrual age. Visualization in all fetuses scanned before 19 weeks' menstrual age improved from 62 (on film only) to 75% (real‐time and film). Abnormalities on the four‐chamber view were demonstrated before 19 weeks of menstrual age in four cases. Although not all serious cardiac defects can be detected, the four‐chamber view remains a reliable screening examination of the fetal heart even early in gestation.