A Simple and Easy Technique for Imaging the Fetal Esophagus in the First, Second, and Third Trimesters Using the Transverse Section of the Esophagus in the Area Behind the Heart as a Reference Point

Venkatesh, Priti

doi:10.1002/jum.14646

Cited by 8 publications

(8 citation statements)

References 7 publications

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“…To our knowledge the only other study that systematically analyzed the esophagus during the first trimester anomaly scan was by Venkatesh 18 . This study included 102 pregnant women at 11–14 weeks of gestation and imaged first a transverse section of the esophagus and then rotated the probe 90° to identify the longitudinal section of the esophagus.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies that evaluated the feasibility of esophageal visualization during the midtrimester anomaly scan [16][17][18][19] have demonstrated the cervical esophagus in 16%-93% of the cases and the thoracic esophagus in 91.7%-99.5% of the cases. At this stage in pregnancy, due to its length and angled course, the esophagus is demonstrated in segments 17 consequently, a small disruption of the esophagus may be missed.…”

Section: Feasibility Of Esophageal Demonstration Throughout Pregnancymentioning

confidence: 99%

“…To our knowledge the only other study that systematically analyzed the esophagus during the first trimester anomaly scan was by Venkatesh. 18 This study included 102 pregnant women at 11-14 weeks of gestation and imaged first a transverse section of the esophagus and then rotated the probe 90°to identify the longitudinal section of the esophagus. Using this technique, the entire length of the esophagus was demonstrated in 88.2% of cases, with the cervical esophagus imaged in 88% of the cases and the thoracic portion imaged in 97% of the cases.…”

Section: Early Pregnancy Esophageal Imaging In the Literaturementioning

confidence: 99%

“…It has been previously shown that the normal appearance of the intact esophagus is an uninterrupted echogenic bundle of fibers, visualized as echogenic lines, which is the sonographic signal projected by the collapsed esophageal muscular walls. 17 In order to improve the detection rate of EA several studies have evaluated the feasibility of demonstrating the fetal esophagus throughout pregnancy including during the midtrimester anomaly scan [16][17][18][19] and during the first trimester anomaly scan. 18 The aim of this study was to describe a "one shot" esophageal imaging technique, visualizing the entire esophagus along its longitudinal axis in a single view, and evaluate the feasibility of its use at first and early second trimester.…”

Section: Introductionmentioning

confidence: 99%

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Fetal esophageal imaging: Early pregnancy as a window of opportunity

et al. 2021

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Objective: To describe the sonographic appearance of the fetal esophagus during early pregnancy and evaluate the feasibility of imaging the entire esophageal length.In addition, we present a case of disrupted esophageal continuity, subsequently diagnosed with esophageal atresia (EA).Methods: A prospective observational study of 145 patients. During the early second trimester anomaly scan performed at 12-17 weeks' gestation the entire esophagus was captured in a single sonographic image at the midsagittal plane (one shot technique). Postnatal follow-up of esophageal patency included review of medical records and telephone interviews.Results: Complete visualization of the esophagus (neck to diaphragm) was possible in 144 cases. In 88% of cases the esophagus was demonstrated by transvaginal approach. The time required to obtain the desired view of the esophagus, once the fetus was in an optimal position, was on average 13 s (range: 5-30 s). In one case at 15 weeks' gestation, the cervical segment of the esophagus was demonstrated while the lower thoracic segment was not identified. Subsequently EA was diagnosed. Conclusions:It is feasible to demonstrate the entire esophagus during early second trimester anomaly scan. An early second trimester anomaly scan may serve as a window of opportunity for EA screening.

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Section: Discussionmentioning

confidence: 99%

Section: Feasibility Of Esophageal Demonstration Throughout Pregnancymentioning

confidence: 99%

Section: Early Pregnancy Esophageal Imaging In the Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fetal esophageal imaging: Early pregnancy as a window of opportunity

et al. 2021

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“…The trachea lies anterior to the spine and can be readily identified as a hypoechoic circular structure surrounded by an echogenic wall. The collapsed esophagus can also frequently be observed at this level as an echogenic structure directly anterior to the spine and posterior to the trachea . The 3VT represents the single best view to evaluate aortic arch sidedness: the aorta coursing to the right of the trachea represents a right aortic arch, whereas an aorta coursing to the left of the trachea represents a left aortic arch.…”

Section: Anatomy and Techniquementioning

confidence: 99%

The Fetal 3‐Vessel Views: An Illustrative Case‐Based Tutorial

Anton

Sklansky

Perez

et al. 2019

J of Ultrasound Medicine

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In 2018, the American Institute of Ultrasound in Medicine revised its obstetric Practice Parameter for the second-trimester fetal anatomic survey. The 2018 Practice Parameter recommends incorporation of the 3-vessel view and 3-vessel and trachea view "if technically feasible." Sonographers and other medical providers may require additional training and education to develop greater proficiency in obtaining and interpreting these views. This pictorial essay, including ultrasound images alongside their respective schematic diagrams, provides an upto-date, practical, and clinically oriented review of the 3-vessel view and 3-vessel and trachea view and their most common presentations in the context of congenital heart disease.

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Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy

Kassif

Weissbach

Kushnir

et al. 2021

Ultrasound in Obstet & Gyne

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Objective Esophageal atresia and/or tracheoesophageal fistula (EA/TEF) remains one of the most frequently missed congenital anomalies prenatally. The aim of our study was to elucidate the sonographic manifestation of EA/TEF throughout pregnancy. Methods This was a retrospective study of data obtained from a tertiary center over a 12‐year period. The prenatal ultrasound scans of fetuses with EA/TEF were assessed to determine the presence and timing of detection of three principal signs: small/absent stomach and worsening polyhydramnios, both of which were considered as ‘suspected’ EA/TEF, and esophageal pouch, which was considered as ‘detected’ EA/TEF. We assessed the yield of the early (14–16 weeks' gestation), routine mid‐trimester (19–26 weeks) and third‐trimester (≥ 27 weeks) anomaly scans in the prenatal diagnosis of EA/TEF. Results Seventy‐five cases of EA/TEF with available ultrasound images were included in the study. A small/absent stomach was detected on the early anomaly scan in 3.6% of fetuses scanned, without a definitive diagnosis. On the mid‐trimester scan, 19.4% of scanned cases were suspected and 4.3% were detected. On the third‐trimester anomaly scan, 43.9% of scanned cases were suspected and 33.9% were detected. An additional case with an esophageal pouch was detected on magnetic resonance imaging (MRI) in the mid‐trimester and a further two were detected on MRI in the third trimester. In total, 44.0% of cases of EA/TEF in our cohort were suspected, 33.3% were detected and 10.7% were suspected but, eventually, not detected prenatally. Conclusions Prenatal diagnosis of EA/TEF on ultrasound is not feasible before the late second trimester. A small/absent stomach may be visualized as early as 15 weeks' gestation. Polyhydramnios does not develop before the mid‐trimester. An esophageal pouch can be detected as early as 22 weeks on a targeted scan in suspected cases. The detection rates of all three signs increase with advancing pregnancy, peaking in the third trimester. The early and mid‐trimester anomaly scans perform poorly as a screening and diagnostic test for EA/TEF. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

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A Simple and Easy Technique for Imaging the Fetal Esophagus in the First, Second, and Third Trimesters Using the Transverse Section of the Esophagus in the Area Behind the Heart as a Reference Point

Cited by 8 publications

References 7 publications

Fetal esophageal imaging: Early pregnancy as a window of opportunity

Fetal esophageal imaging: Early pregnancy as a window of opportunity

The Fetal 3‐Vessel Views: An Illustrative Case‐Based Tutorial

Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy

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