Performance of First‐Trimester Fetal Echocardiography in Diagnosing Fetal Heart Defects: Meta‐analysis and Systematic Review

2019 ◽  
Vol 39 (3) ◽  
pp. 471-480
Author(s):  
Dongmei Yu ◽  
Lun Sui ◽  
Nan Zhang
Keyword(s):  
Systematic Review ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Meta Analysis ◽  
First Trimester

Echocardiography in Early Pregnancy

2013 ◽  
Vol 7 (2) ◽  
pp. 168-181 ◽  
Author(s):  
Carmen Comas ◽  
Pilar Prats RodrRguez
Keyword(s):  
High Risk ◽  
Early Pregnancy ◽  
Fetal Heart ◽  
Early Stage ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Transvaginal Ultrasound ◽  
First Trimester ◽  
Slight Reduction

ABSTRACT Within the last decade, two significant events have contributed to the increasing interest in early fetal echocardiography. First, the introduction of high frequency vaginal ultrasound probes allows detailed visualization of cardiac structures at early stage of gestation, making early detection of fetal malformations possible. Second, the close relationship observed between some first trimester sonographic and Doppler markers and congenital heart defects allows an early identification of a high-risk group at 11 to 14 weeks of gestation. In this context, from the early 1990s, many authors have examined the potential role of the transvaginal approach to obtain earlier diagnosis of fetal cardiac malformations. Further studies have appeared in the literature showing that early transvaginal echocardiography in experienced hand is a fairly sensitive investigative tool. Although some malformations are detected as early as 11 weeks’ gestation, the optimal gestational age to perform the early scan is at least 13 weeks’ gestation. Transvaginal ultrasound is the preferred approach, although most of the authors agree that results can be improved if transabdominal ultrasound is also incorporated. The further application of color Doppler enhances visualization. The sensitivity and specificity of early fetal echocardiography for the detection of heart anomalies is acceptable compared to the ones obtained by mid-gestational echocardiography, showing a slight reduction in detection rates and an increase in false positive and negative rates. The cardiac anomalies detected at this early stage of pregnancy are mainly defects involving the four-chamber view, indicating that defects solely affecting the outflow tracts are difficult to diagnose in the first trimester of pregnancy. Heart defects diagnosed early in pregnancy tend to be more complex than those detected later, with a higher incidence of associated structural malformations, chromosomal abnormalities and spontaneous abortions. The neonate follow-up or postmortem examination in case of termination of pregnancy (TOP) is essential to assess the actual role of early fetal echocardiography. At present, early fetal echocardiography is a promising technique, which can be of considerable value for patients at high-risk. This technique is, however, currently limited to a few specialized centers. The aim of this review is to explore the possibilities of examining the fetal heart at this early stage of pregnancy. This article also present our experience in the first multicenter trial in early fetal echocardiography performed in Spain. In accordance with other studies, this experience stresses the usefulness of early echocardiography when performed by expert operators on fetus specifically at risk for cardiac defects. Our review of these additional 48 cases contributes to the expanding literature on the ability of transvaginal ultrasonography to detect fetal heart defects in early pregnancy. How to cite this article Gabriel CC, Rodriguez PP. Echocardiography in Early Pregnancy. Donald School J Ultrasound Obstet Gynecol 2013;7(2):168-181.

scholarly journals First trimester ultrasound for the detection of fetal heart anomalies: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
J. N. Karim ◽  
E. Bradburn ◽  
N. Roberts ◽  
A. T. Papageorghiou ◽  
Aris T. Papageorghiou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fetal Heart ◽  
Meta Analysis ◽  
First Trimester ◽  
First Trimester Ultrasound

scholarly journals Early Fetal Echocardiography

2017 ◽  
Vol 11 (1) ◽  
pp. 29-43
Author(s):  
Pilar Prats ◽  
Carmina Comas
Keyword(s):  
High Risk ◽  
Fetal Heart ◽  
Early Stage ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Transvaginal Ultrasound ◽  
False Negative ◽  
First Trimester ◽  
Slight Reduction

ABSTRACT Within the last decade, two significant events have contributed to the increasing interest in early fetal echocardiography. First, the introduction of high-frequency vaginal ultrasound probes allows detailed visualization of cardiac structures at early stage of gestation, making early detection of fetal malformations possible. Second, the close relationship observed between some first trimester sonographic and Doppler markers and congenital heart defects allows an early identification of a high-risk group at 11 to 14 weeks of gestation. In this context, from the early 1990s, many authors have examined the potential role of the transvaginal (TV) approach to obtain earlier diagnosis of fetal cardiac malformations. Further studies have appeared in the literature showing that early TV echocardiography in experienced hands is a fairly sensitive investigative tool. Although some malformations are detected as early as 11 weeks gestation, the optimal gestational age to perform the early scan is at least 13 weeks gestation. Transvaginal ultrasound is the preferred approach, although most of the authors agree that results can be improved if transabdominal ultrasound is also incorporated. The further application of color Doppler enhances visualization. The sensitivity and specificity of early fetal echocardiography for the detection of heart anomalies is acceptable compared with the ones obtained by midgestational echocardiography, showing a slight reduction in detection rates and an increase in false-positive and false-negative rates. The cardiac anomalies detected at this early stage of pregnancy are mainly defects involving the four-chamber view, indicating that defects solely affecting the outflow tracts are difficult to diagnose in the first trimester of pregnancy. Heart defects diagnosed early in pregnancy tend to be more complex than those detected later, with a higher incidence of associated structural malformations, chromosomal abnormalities, and spontaneous abortions. The neonate follow-up or postmortem examination in case of termination of pregnancy is essential to assess the actual role of early fetal echocardiography. At present, early fetal echocardiography is a promising technique, which can be of considerable value for patients at high risk. This technique is, however, currently limited to a few specialized centers. The aim of this review is to explore the possibilities of examining the fetal heart at this early stage of pregnancy. This article also presents our experience in the first multicenter trial in early fetal echocardiography performed in Spain. In accordance with other studies, this experience stresses the usefulness of early echocardiography when performed by expert operators on fetus specifically at risk for cardiac defects. Our review of these additional 48 cases contributes to the expanding literature on the ability of TV ultrasonography to detect fetal heart defects in early pregnancy. How to cite this article Comas C, Prats P. Early Fetal Echocardiography. Donald School J Ultrasound Obstet Gynecol 2017;11(1):29-43.

scholarly journals Fetal Tricuspid Regurgitation in the First Trimester as a Screening Marker for Congenital Heart Defects: Systematic Review and Meta-Analysis

2017 ◽  
Vol 42 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Carolina Scala ◽  
Maddalena Morlando ◽  
Alessandra Familiari ◽  
Umberto Leone Roberti Maggiore ◽  
Simone Ferrero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Tricuspid Regurgitation ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
First Trimester ◽  
Screening Marker

scholarly journals Children Born with Congenital Heart Defects and Growth Restriction at Birth: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (9) ◽  
pp. 3056 ◽  
Author(s):  
Ali Ghanchi ◽  
Neil Derridj ◽  
Damien Bonnet ◽  
Nathalie Bertille ◽  
Laurent J. Salomon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Growth Restriction

Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted. Objective: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA). Methods: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model. Results: The pooled proportion of SGA in all CHD was 20% (95% CI 16%–24%) and 14% (95% CI 13%–16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%–37%) for Tetralogy of Fallot to 12% (95% CI 7%–18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010. Conclusion: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.

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