Color Doppler flow mapping of fetal heart

Gembruch, Ulrich; Chatterjee, Molly S.; Bald, R.; Redel, D. A.; Hansmann, M.

doi:10.1515/jpme.1991.19.1-2.27

Cited by 19 publications

(10 citation statements)

References 7 publications

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“…Color Doppler has been shown to confirm the patency of ventricular inflows, outflows, anatomy, and flow through the arches; competency of AV and semilunar valves; appropriate connection of systemic and pulmonary veins; and documentation or exclusion of septal defects. [199][200][201] In the normal fetus, it reduces scanning times, permitting rapid assessment of the relationship and patency of cardiac structures. 199 It facilitates recognition of normal and abnormal anatomy when 2D image resolution is suboptimal 199 and may be especially helpful at earlier gestational ages.…”

Section: Doppler Imagingmentioning

confidence: 99%

“…200 In another large study, color-flow mapping was shown to be additive, particularly with the detection of AV valve insufficiency, demonstration of turbulent high-velocity jets of semilunar valve stenosis, altered ductal and distal arch flow, and septal defect shunting. 201 More subtle outflow tract obstruction has been identified through the detection of flow acceleration across the pulmonary or aortic valves that may otherwise have been missed in routine 2D imaging. 203 In the presence of more severe fetal CHD, abnormal flow patterns through the ductal or aortic arch, particularly flow reversal as identified by color and pulsed Doppler, have been shown to herald the presence of critical pulmonary or aortic outflow tract obstruction.…”

Section: Doppler Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

983

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Section: Doppler Imagingmentioning

confidence: 99%

Section: Doppler Imagingmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

983

543

View full text Add to dashboard Cite

show abstract

“…The use of color Doppler is not considered mandatory in the second trimester screening, but its use is, however, encouraged [22]. It has mainly been used to achieve additional information about already detected CHD, in particular complex cases and its use for screening is controversial [17,18]. Eggebo et al found color-Doppler useful in the screening situation in Norway where 9/26 findings of CHD were related to the additional information given by the color.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that using a systematic approach when examining the fetal heart facilitates the confirmation of normality and also makes it easier to recognize abnormalities [10,13-16]. If color-Doppler is added to the examination, rapid screening to detect flow abnormalities of the fetal heart may be carried out [17]. This view is supported by Chaoui et al who suggest that color-Doppler should be added to the screening for CHD in order to allow easy detection of the majority of CHD [18].…”

Section: Introductionmentioning

confidence: 99%

Impact of a standardized training program on midwives’ ability to assess fetal heart anatomy by ultrasound

et al. 2014

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BackgroundStudies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden.MethodsA novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of two experienced and two beginner midwives were identified. A two-day course with mixed lectures, demonstrations and hands-on sessions was followed by a feedback session three months later consisting of an interview and check-up. The long-term effects were tested two years later.ResultsAt the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have improved their ability to use the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later.ConclusionsOur results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and examination time decreased, but they also show that continuous on-site training with clinical and technical back-up is important.

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“…It adds¯ow pattern information to echocardiographic ®ndings and aids prenatal diagnosis of intracardiac shunts, anomalies of the great vessels, valve insuf®ciency and valve obstruction. 77,78 Copel et al (1991) 62 required colour¯ow mapping to diagnose 29% of fetuses with cardiac malformations. It proved helpful in a further 47% of cases.…”

Section: Fetal Echocardiographymentioning

confidence: 99%