Evaluation of fetal circulation in the late first trimester – preliminary study.

Abstract

Evaluation of fetal circulation in the late first trimester – preliminary study. Objectives: to confirm that fetal echocardiography is indeed possible in late first trimester and that it improves the standard of the so-called “genetic” ultrasound scan. Material and methods: Early echocardiography was performed in 75 fetuses from high and low risk pregnancies. All fetuses underwent echocardiography examination in 18-22 weeks of gestation and established follow up. Results: The most suitable method of visualization seems to be transabdominal examination, between 13,0-13,6 weeks of gestation, an transvaginal one, between 12,0-12,6 weeks of gestation, with 90% effectiveness. In researched group of 75 fetuses (with established follow up) there were four heart defects (5,3%). Three of them were diagnosed before 14th week of gestation. One case (tetralogy of Fallot) was overlooked. There were two false positive diagnosis verified at 20th week of gestation. Conclusions: Early echocardiography, especially between 12,0-13,6 weeks of gestation, is a possible and valuable method of diagnosis. Reference evaluation should be performed between 18 and 22 weeks of gestation. In cases with suspected anomalies karyotyping is recommended. Congenital heart disease diagnosed at late first trimester should be treated as the next potential marker of genetic disorder.