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KMID : 1201620100030010001
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Journal of Women s Medicine
2010 Volume.3 No. 1 p.1 ~ p.2
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Prenatal diagnosis of cardiac defect
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Tanaka Mamoru
Miyakoshi Kei
Minegishi Kazuhiro
Yoshimura Yasunori
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Abstract
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Fetal cardiac malformations are the most common congenital malformations with an incidence of 8:1000 among live births. Furthermore, 10% of neonatal deaths and up to 50% of infant deaths were attributed to congenital anomalies. In 2006 the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) published practice guidelines for the sonographic screening of congenital heart disease (CHD) at some time between 18 and 22 weeks’ gestation. Two levels for screening low-risk fetuses for heart anomalies are recommended. Firstly, a basic scan should be performed by analyzing a four-chamber view of the fetal heart. Secondly, an extended-basic scan further examines the size and relationships of both arterial outflow tracts. Obstetricians, midwives, and perinatalogists are able to evaluate a thorough examination of the four-chamber view, both arterial outflow tracts, three vessels and trachea view, and an assessment of pulmonary venous return. These anatomical features are usually evaluated using transverse views, although sagittal scanning planes are also used as necessary. Color doppler ultrasonography is an important component of the fetal echocardiogram. Occasionally, advanced techniques such as Velocity Vector Imaging (VVI) may be required to evaluate fetal cardiac function using measurements of ventricular ejection fraction, stroke volume, and ventricular strain parameters. An accurate prenatal diagnosis of cardiac defects, especially ductal dependent anomaly, is extremely important for healthcare professionals who will be counseling parents about the nature, severity, clinical management and prognosis of their unborn child.
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KEYWORD
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Fetal echocardiography, congenital heart defects
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