Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
-
Antongiulio Del Bianco
Abstract
Objective: To test the efficacy of a recently introduced ultrasonic scanning plane (three vessel and trachea view -3VTV- plus color flow mapping -3VTVC) on a low-risk population for detection of congenital heart disease (CHD).
Patients and setting: Antenatal clinic dealing with local low-risk population. All antenatal patients having a second trimester scan in a 1 year period. All patients had a 3VT plus 3VTC views added to routine four chamber view. Postnatal examinations were performed according to standard hospital protocol.
Results: 2847 patients were examined. The plane was achievable in all 23 fetuses with CHD detected, three false negative (aortic coarctation) and two false positive. Sensitivity of the examination was 88.5%, as high as more sophisticated and difficult targeted cardiac scanning. The extra time necessary to perform the test was minimal.
Conclusion: 3VTV and 3VTCV were satisfactory used as imaging planes in a busy antenatal clinic in a low-risk population. They could be easily added to the four chamber view as routine screening for CHD and increase the detection rate to 90%.
References
1 Bonnet D, A Coltri, G Butera, L Fermont, J Le Bidois, J Kachner, D Sidi: Detection of transposition of great arteries in fetuses reduces neonatal morbidity and mortality. Circulation9 (1999) 916Search in Google Scholar
2 Chaoui R, R McEwing: Three cross-sectional planes for fetal color Doppler echocardiography. Ultrasound Obstet Gynecol21 (2003) 81Search in Google Scholar
3 Copel J, G Pilu G, J Green, JC Hobbins, CS Kleinman: Fetal echocardiography screening for congenital heart disease: the importance of the four chamber view. Am J Obstet Gynecol157 (1987) 648Search in Google Scholar
4 Franklin O, M Burch, N Manning, K Sleeman, S Gould, N Archer: Prenatal diagnosis of the coarctation of the aorta improves survival and reduces morbidity. Heart87 (2002) 67Search in Google Scholar
5 Hoffman JIE: Incidence of congenital heart disease. II. Prenatal incidence. Pediatr Cardiol16 (1995) 15510.1007/BF00801907Search in Google Scholar PubMed
6 Hoffman JIE: Incidence of congenital heart disease. I. Postnatal incidence. Pediatr Cardiol16 (1995) 10310.1007/BF00801907Search in Google Scholar
7 Kumar RK, IW Newburger, K Gauvreau, S Kamenir, LK Hornberger: Comparison of outcome when hypoplastic left heart syndrome and transposition of the great arteries are diagnosed prenatally versus when diagnosis of two conditions is made postnatally. Am J Cardiol83 (1999) 1649Search in Google Scholar
8 Rustico MA, A Benettoni, G D'Ottavio, A Maieron, I Fisher-Tamaro, G Conoscenti, Y Meir, M Montesano, A Cattaneo, G Mandruzzato: Fetal heart screening in low-risk pregnancies. Ultrasound Obstet Gynecol6 (1995) 313Search in Google Scholar
9 Sharland GK, LD Allan: Screening for congeniotalheart disease prenatally: results of a 2 and 1/2-year study in the South East Thames region. Br J Obstet Gynecol99 (1992) 220Search in Google Scholar
10 Società Italiana di Ecografia Ostetrica e Ginecologica. Editeam (eds): Linee Guida SIEOG. Roma, 2002Search in Google Scholar
11 Vimercati A, P Greco, G Calducci, G Caruso, G Ingravallo, V Loizzi, G Loverro, L Selvaggi: Experience with first level ultrasound and echocardiography for a selected and un-selected population. J Perinat Med30 (2002) 231Search in Google Scholar
12 Vinals F, F Heredia, A Giuliano: The role of three vessels and trachea view (3VT) in the diagnosis of congenital heart defects. Ultrasound Obstet Gynecol22 (2003) 358Search in Google Scholar
13 Wigton TR, RE Sabbagha, RK Tamura, L Cohen, JP Minogue, JF Strasburger: Sonographic diagnosis of congenital heart disease: comparison between the four chamber view and multiple cardiac views. Obstet Gynecol82 (1993) 219Search in Google Scholar
14 Yagel S, R Arbel, EY Anteby, D Raveh, R Achiron: The three vessels and trachea view (3VT) in fetal cardiac scanning. Ultrasound Obstet Gynecol20 (2002) 340Search in Google Scholar
15 Yoo SJ, YH Lee, ES Kim, HM Ryu, MY Kim, HK Choi, KS Cho, A Kim: Three vessel view of the upper mediastinum: an easy means of detecting abnormalities of the ventricular outflow tracts and great arteries during obstetric screening. Ultrasound Obstet Gynecol9 (1997) 173Search in Google Scholar
©2006 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Advances in Perinatal Medicine - 5th Annual meeting of the Italian Society of Perinatal Medicine held in Parma, Italy on June 15th – 17th 2006
- Hemorrhagic shock in obstetrics
- Altered protease expression by periarterial trophoblast cells in severe early-onset preeclampsia with IUGR
- Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy
- Accuracy and influence of ascorbic acid on glucose-test with urine dip sticks in prenatal care
- Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study
- Timing of cord clamping revisited
- Intrapartum cardiotocography – the dilemma of interpretational variation
- Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants
- Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
- Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero
- Fetal brain sparing is strongly related to the degree of increased placental vascular impedance
- Outcome of fetuses in women with pregestational diabetes mellitus
- Outcome of fetuses in women with pregestational diabetes mellitus
- Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn
- To drain or not to drain: a single institution experience with neonatal intestinal perforation
- Infective puerperal endocarditis caused by Escherichia coli
- Correlation between plasma and urinary caffeine levels in preterm infants
- Fetal ascites secondary to urinary hydrocolpos
- Congress Calendar
- Suppression of IL-2 and IFN-γ production in women with spontaneous preterm labor
Articles in the same Issue
- Advances in Perinatal Medicine - 5th Annual meeting of the Italian Society of Perinatal Medicine held in Parma, Italy on June 15th – 17th 2006
- Hemorrhagic shock in obstetrics
- Altered protease expression by periarterial trophoblast cells in severe early-onset preeclampsia with IUGR
- Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy
- Accuracy and influence of ascorbic acid on glucose-test with urine dip sticks in prenatal care
- Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study
- Timing of cord clamping revisited
- Intrapartum cardiotocography – the dilemma of interpretational variation
- Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants
- Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
- Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero
- Fetal brain sparing is strongly related to the degree of increased placental vascular impedance
- Outcome of fetuses in women with pregestational diabetes mellitus
- Outcome of fetuses in women with pregestational diabetes mellitus
- Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn
- To drain or not to drain: a single institution experience with neonatal intestinal perforation
- Infective puerperal endocarditis caused by Escherichia coli
- Correlation between plasma and urinary caffeine levels in preterm infants
- Fetal ascites secondary to urinary hydrocolpos
- Congress Calendar
- Suppression of IL-2 and IFN-γ production in women with spontaneous preterm labor