Indications for Fetal Echocardiography

Small, Maria; Copel, Joshua A.

doi:10.1007/s00246-003-0587-z

Cited by 61 publications

(44 citation statements)

References 84 publications

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“…94 Because of the perception that the inflammatory effects resulting from antibody exposure may be preventable if detected and treated at an early stage, it has been recommended that SSA/SSB-positive women be referred for fetal echocardiography surveillance beginning in the early second trimester (16-18 weeks). 14,16,95 The mechanical PR interval has been measured in fetuses at risk with the use of a variety of M-mode and pulsed Doppler techniques and compared with gestational age-adjusted normal values. 96 Although the value of serial assessment for the detection of the progression of myocardial inflammation or conduction system disease from first-degree block (PR prolongation) to CHB has not been proved, serial assessment at 1-to 2-week intervals starting at 16 weeks and continuing through 28 weeks of gestation is reasonable to perform because the potential benefits outweigh the risks.…”

Section: Autoimmune Disease and Autoantibody Positivitymentioning

confidence: 99%

“…The frequent association of fetal cardiac anomalies with other extracardiac anomalies drives the need for any fetus identified as having CHD to have a thorough detailed ultrasound examination of all other fetal anatomy. 68,95,194 Other imaging modalities, including MRI, have also been used in this population. Even with vigilance and high index of suspicion, a significant number of extracardiac anomalies may go undetected or may be undetectable until later in gestation (as may be the case with some gastrointestinal anomalies); therefore, a low threshold for repeat anatomic assessment later in gestation after an initially normal extracardiac evaluation may be appropriate in some instances.…”

Section: Genetic Testing Of Fetuses With Chdmentioning

confidence: 99%

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Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

979

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: Autoimmune Disease and Autoantibody Positivitymentioning

confidence: 99%

Section: Genetic Testing Of Fetuses With Chdmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

979

543

View full text Add to dashboard Cite

show abstract

“…Fetal echocardiography (FE) is often performed when fetuses are at risk for CHD. [4][5][6][7][8] Many patients would have previously undergone an evaluation of the fetal heart during detailed fetal anatomic ultrasonography (FAU). The utility of FE after adequate FAU is unclear.…”

mentioning

confidence: 99%

Utility of Fetal Echocardiography After Normal Cardiac Imaging Findings on Detailed Fetal Anatomic Ultrasonography

Starikov

Bsat

Knee

et al. 2009

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to assess the utility of fetal echocardiography (FE) after normal fetal cardiac imaging findings during detailed fetal anatomic ultrasonography (FAU). Methods. We conducted a retrospective cohort review of obstetric ultrasonographic studies from November 2001 through July 2005. We identified women with a singleton gestation with increased risk for congenital heart disease who received FAU performed by a maternal-fetal medicine specialist at 16 to 20 weeks' gestation with subsequent FE. These records were compared with newborn outcomes. Results. Of 789 pregnancies that had FAU and FE, 481 had satisfactory cardiac imaging. Of those, only 1 fetus had abnormal FE findings. After delivery, 4 of the 480 neonates with normal FAU and FE findings had a diagnosis of a heart defect. Conclusions. Fetal echocardiography does not substantially increase the detection rate of major cardiac anomalies after normal findings on detailed FAU performed by a maternal-fetal medicine specialist.

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“…8,9 However, most cases are not associated with known risk factors. Common indications for a detailed scan of the fetal heart include but are not limited to:…”

Section: Indicationsmentioning

confidence: 99%

AIUM Practice Guideline for the Performance of Fetal Echocardiography

Gynecologists¹

2011

Journal of Ultrasound in Medicine

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Indications for Fetal Echocardiography

Cited by 61 publications

References 84 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

Utility of Fetal Echocardiography After Normal Cardiac Imaging Findings on Detailed Fetal Anatomic Ultrasonography

AIUM Practice Guideline for the Performance of Fetal Echocardiography

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