Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Abstract

Fetal echocardiography has evolved considerably over the past 1-2 decades into an exciting field that bridges maternal-fetal medicine with neonatology and pediatric cardiology. With significant advances in imaging technology and experience in prenatal diagnosis, details of the cardiac pathology can now be defined much as it is postnatally; however, unique aspects of the fetal circulation limit our ability to consistently define lesion severity and to predict the evolution of cardiac defects after birth. Serial assessment has provided an understanding of the antenatal natural history of fetal heart disease, which has led to improved counseling and perinatal/neonatal management strategies. More recently, this field has focused on improving our evaluation of fetal arrhythmias, exploring the pathophysiology of fetal heart failure, detecting heart defects at earlier gestational ages, identifying novel interventions to alter the development and progression of severe disease, and investigating strategies to optimize prenatal and neonatal care in an effort to improve perinatal outcome of affected pregnancies. In this paper we will review the current state of the art of fetal/perinatal cardiology and the advances that have occurred in the field largely over the past decade.