Journal of Korean Society of Medical Ultrasound 1997;16(4): 299-306.
Screening Fetal Echocardiography Made Easy.
Shi Joon Yoo, Young Ho Lee
1Department of Ultrasound, Samsung-Cheil Hospitl, Korea. joonyoo@samsung.co.kr
2Department of Radiology, Sejong Heart Institute, Korea.
  Published online: January 1, 2001.
ABSTRACT
Examination of fetal heart with a four-chamber view is an excellent screening test. Nevertheless, it has certain limitations in detection of significant proportion of major congenital heart diseases. To compensate for this weakness of the use of a four-chamber view alone, we extended our screening examination to include 1) transverse view of the upper abdomen, 2) four-chamber view, 3) three-vessel view, 4) left ventricular outflow tract view, 5) right ventricular outflow tact view, and 6) aortic arch view. Although our protocol is rather extensive, we developed an easy method to obtain these 6 basic views in 5-10 minutes in about 90% of cases. We start our examination from the transverse view of the upper abdomen. We then slide the transducer cranially along the long axis of the fetal body to reach the four-chamber plane and then to the three-vessel plane. We come back to the four-chamber plane and move the transducer radially around the maternal abdomen to place the ventricular septum perpendicular to the sonographic beam axis. We then rotate the transducer clockwise or counterclockwise toward the cardiac apex and obtain the left and right ventricular outflow tract views. Finally, we obtain the aortic arch view with a guide of the positions of the ascending and descending aorta at the three-vessel view. By using our extended examination protocol, we detected 42 cases with major congenital heart disease and 22 with minor lesion among 7,379 cases in 1996. This data suggest that our protocol is very efficient in detecting congenital heart disease.
Keywords: Fetal echocardiography; Screening; Congenital heart disease
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