Cardiac axis evaluation as a screening method for detecting cardiac abnormalities in the first trimester of pregnancy

Abstract

Congenital cardiac abnormalities refer to especially anatomic malformations of the heart that normally occur during fetal heart development, before eight weeks after conception. Aim: The aim is to investigate the association between cardiac axis and congenital heart abnormalities for a potential underline clinical application of cardiac axis evaluation during detection by abnormalities at the time of first trimester ultrasound. It is known that aneuploids can be associated in almost half of cases with cardiac abnormalities, so the angle of the cardiac axis could be a potential indirect marker for the detection of aneuploids in the first trimester of pregnancy. Being easy to obtain, from the cross-section at the chest level with the visualization of the four chambers, does not require additional sections to those provided in the current guides, we aim to prove its usefulness in diagnosing aneuploids and congenital cardiac abnormalities along with the translucent nuchal flow, at the level of the venous duct and the presence of tricuspid regurgitation. Conclusions: Cardiac axis has a higher value for the detection of congenital cardiac abnormalities with respect to the nuchal translucency, tricuspid regurgitation and inverted A wave at the level of the venous duct.

Cardiopulmonary Arrest During Pregnancy: A Review Article

“…Some 60% of serious cardiac issues can only be found by looking at the heart during a four-chamber section, and even then, it takes later echocardiography throughout pregnancy to spot an abnormal four-chamber section. This approach for cardiac screening during the first trimester of pregnancy has just recently become available [ 22 ].…”

First Trimester Tricuspid Regurgitation: Clinical Significance

“…The early identification of CHD has several benefits; it can help the family make decisions, namely about the possibility of terminating the pregnancy, earlier, safely, and more privately, and consequently, with a lower psychological impact [ 57 ]. It also allows sufficient time for a genetic evaluation, which is necessary to differentiate an isolated structural defect or, on the other hand, that contained in a genetic syndrome, along with determining the consequences that it entails [ 59 , 61 , 62 ].…”

“…The effectiveness of cardiac assessment in the first trimester may be affected by the small size of the fetus [ 14 ] and the fact that some anomalies are insidious and only become evident in later pregnancy [ 12 ]. Despite this, more than half of major heart defects can be detected on first-trimester ultrasound [ 3 ], and additional ultrasound markers may indirectly suggest the presence of cardiac anomalies [ 62 ]. The presence of TR is one of the examples of an easily detectable ultrasound marker that can alert to a possible CHD [ 7 ].…”

Epidemiological Study on Spinal Cord Injuries in a Hospital from North-West of Romania

“…Particularly in high cervical and thoracic injuries, disruption of sympathetic outflow plays a key role in cardiovascular dysfunction [32]. Loss of supraspinal regulatory control of the sympathetic nervous system results in the reduced overall sympathetic activity below the level of injury and causes problems such as hypotension, bradycardia, and a diminished cardiovascular response to exercise [33][34][35]. Morphological changes occur in sympathetic preganglionic neurons distal to the lesion [36].…”