P26.13: Feasibility of first trimester fetal echocardiography in routine clinical work

Abstract

Objectives: To assess extent of recognition of major fetal heart structures by transabdominal high frequency probe in first trimester in routine clinical work. Methods: From January 2011 to June 2011, 242 women had 11-14 week scan by two FMF certified operators. Examination of fetal morphology, including heart, as well as chromosomal abnormalities screening was done in allocated period of 30 min. We checked if it is possible to see 4-chamber view, AV valves, ventricles, left and right outflow tract, three vessel view, aortic arch and VCI in different gestations (55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80). All scans were done transabdominally, with a high frequency probe, cardiac setting (Accuvix, Medison), and no colour Doppler was applied. Results: When CRL was 45-54 mm, 4cv was seen in 60% of cases, while 3vv in 2%. Starting from CRL 65 mm, 4cv was seen in all cases, whereas 3vv was seen in one third (table 1). All scans were done within allocated 30 min. BMI influenced visibility when structures were not easy to be seen (e.g. in CRL 45-54 mm group mean BMI when ventricles are seen was 22.8, when not 28.6 (P = 0.039). When the structures were difficult to be seen, even in late first trimester, BMI did not make a difference (in 75-84 mm group mean BMI when 3vv was seen was 22.5, when not 22.7 (P = 0.901). Conclusions: Major cardiac structures can be seen in first trimester with different rate of success, depending on gestation and it is possible to do it without extending the usual duration of scan. Four chamber view is the first to be reliably seen, whereas examination of great arteries during this period remains challenging. Objectives: To demonstrate changing antenatal detection rate of isolated congenital heart defects by routine fetal anomaly screening. Methods: Data were obtained from the regional congenital anomaly register for Wessex for the period 1994-2010. This has high ascertainment for both antenatally and postnatally diagnosed anomalies and covers ten maternity units in central southern England and the Channel Islands. We confined our analysis to isolated cardiac anomalies after excluding chromosomal or major structural extra-cardiac anomalies. Results: There were 461,000 births between 1994 and 2010. There were 2017 cases of confirmed congenital heart disease detected before or after birth. We have confined our analysis to 1393 isolated cardiac anomalies without chromosomal or major structural extracardiac anomalies. ASD and VSD may be difficult or impossible to detect antenatally so we have shown antenatal detection rates for isolated cardiac anomalies with these included or excluded. Conclusions:The results show improving antenatal detection rates over the years. P26.14: Table 1. Antenatal detection of isolated cardiac anomalies 1994-2010 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2010All Expert system (GE). All cases were first examined with conventional 2D ultrasound for assessment of the type and prognosti...