Document Detail


Changes in fetal cardiac geometry with gestation: implications for 3- and 4-dimensional fetal echocardiography.
MedLine Citation:
PMID:  17384040     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Three- and 4-dimensional fetal echocardiography can be performed using novel algorithms. However, these algorithms assume that the spatial relationships among cardiac chambers and great vessels are constant throughout gestation. The objective of this study was to determine whether changes in fetal cardiac geometry occur during gestation.
METHODS: A cross-sectional study was conducted by reviewing 3- and 4-dimensional volume data sets from healthy fetuses obtained between 12 and 41 weeks of gestation. Volume data sets were examined using commercially available software. Parameters measured included angles between: (1) the ductal arch and fetal thoracic aorta; (2) the ductal arch and aortic arch; and (3) the left outflow tract and main pulmonary artery, as seen in the short axis of the heart. The mean angle from the left outflow tract to the short axis was calculated. Nonparametric statistics were used for analysis.
RESULTS: Eighty-five fetuses were included in the study. The angle between the ductal arch and the fetal thoracic aorta decreased with gestational age (Spearman rho coefficient: -0.39; P < .001). In contrast, the angle between the ductal arch and aortic arch, and the mean angle between the left outflow tract and the short axis of the heart increased with gestational age (Spearman rho coefficients: 0.45 and 0.40, respectively; P < .001).
CONCLUSIONS: (1) Changes in fetal cardiac geometry were shown with advancing gestational age. (2) Proposed algorithms for the examination of the fetal heart with 3-dimensional ultrasonography may need to be adapted to optimize visualization of the standard planes before 26 weeks of gestation.
Authors:
Jimmy Espinoza; Francesca Gotsch; Juan Pedro Kusanovic; Luís F Gonçalves; Wesley Lee; Sonia Hassan; Pooja Mittal; Mary Lou Schoen; Roberto Romero
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  26     ISSN:  0278-4297     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-06-07     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  437-43; quiz 444     Citation Subset:  IM    
Affiliation:
Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland/Detroit, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Aorta, Thoracic / embryology*,  ultrasonography
Cross-Sectional Studies
Ductus Arteriosus / embryology*,  ultrasonography
Echocardiography, Four-Dimensional
Echocardiography, Three-Dimensional
Female
Fetal Heart / anatomy & histology*,  ultrasonography
Gestational Age
Humans
Pregnancy
Ultrasonography, Prenatal / methods*
Grant Support
ID/Acronym/Agency:
Z01 HD002401-15/HD/NICHD NIH HHS; Z99 HD999999/HD/NICHD NIH HHS
Comments/Corrections

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