Fetal Heart Size

Abstract

This study shows high R values when comparing measurements of the area and circumference against 7 independent variables, irrespective of whether the point-to-point trace or the electronic ellipse method was used to obtain the measurements. A calculator to evaluate the area and circumference is provided, using 7 independent variables from which Z scores and percentiles for individual measurements can be computed.

Evaluation of Foetal Cardiothoracic Ratio in Normal Pregnancy: Correlation with Gestational Age, Foetal Weight and Established Nomogram

“…Yet another important benefit of this normative data displaying the 5 th to 95 th percentiles for CT diameter ratios presented here is the fact that it would beyond aiding in foetal gestational age and weight assessment, be helpful in the early detection of foetal cardiomegaly, as has been previously documented in other climes [1,8,21]. The particular usage of the CT diameter ratio has also been corroborated by the studies to be most valuable in detecting cardiomegaly when the CT ratio is above the 95 th percentile [4]. Despite all efforts to ensure perfect measurements, we cannot exclude some errors probably due to unfavourable foetal positioning, acoustic shadowing caused by foetal bony structures and maternal habitus at later gestations.…”

“…On chest xray, the CT ratio is generally used to evaluate heart size in relation to the thorax in children and adults [1]. An important sign of congenital heart disease (CHD), myocardial dysfunction and foetal congestive cardiac failure is cardiomegaly, which is detected using the assessment of the CT ratio [1][2][3][4][5][6]. Measurement of heart size is a fundamental element in the screening for foetal cardiac diseases [3].…”

“…However, several recommendations for foetal sonographic cardiac evaluation do not suggest routine screening using CT ratio measurement [3,6,7]. Other methods are assessment of cardiac volume, cardiac area and circumference, estimation of gestational age, measurement of biparietal diameter and other foetal biometric indices [1,4,8]. There are three ways to calculate the CT ratio: by dividing the cardiac diameter by the thoracic diameter (also known as the CT diameter ratio), by dividing the cardiac circumference by the thoracic circumference (also known as the CT circumference ratio), and by dividing the cardiac area by the thoracic area (also known as the CT area ratio).…”

Enhancement of the screening examination of the fetal heart as proposed by ISUOG Practice Guidelines

“…In the multimedia tutorial (Videoclip S1 (at 07:12 min)), I illustrate a simple technique to measure the end-diastolic area of the four-chamber view using the end-diastolic length and width measurements (Figure 3) and provide a calculator (Appendix S1) to compute the Z-score and percentile of the heart measurements, which will allow the examiner to determine if cardiomegaly is present 3,4 . Abnormalities of the size and shape of the four-chamber view have been associated with the ventricular dysfunction observed in fetal growth restriction, as well as with structural malformations of the outflow tracts and over 35 other fetal abnormalities 3,5 .…”

Reference Ranges and Development Patterns of Fetal Myocardial Function Using Speckle Tracking Echocardiography in Healthy Fetuses at 17 to 24 Weeks of Gestation

“…with expertise in fetal echocardiography and speckle tracking analysis. 16,20,[24][25][26][27][28][29][30][31][32][33] Ventricular Endocardial Measurements Using Speckle Tracking Analysis 2D images of the 4CV were imported into an offline cardiac software program (2D Fetal Cardiac Performance Analysis [2D CPA]), developed by TomTec Imaging Systems, Gmbh (Munich, Germany), using criteria for fetal applications that have been described previously. 30 The endocardial enddiastolic and end-systolic borders were defined using the quiver technique.…”