Advanced Fetal Echocardiography

Abstract

In recent years, fetal echocardiography for congenital heart disease (CHD) has become a part of routine medical care. Fetal echocardiography for CHD is divided into screening and scrutiny. Although the two differ in terms of the observation range, they both check the left and right sides and visualize the abdominal cross section, the four-chamber view, the left and right outflow tracts, the three-vessel view, the three-vessel trachea view, the aortic arch, and the basic cross section, respectively performing screening and scrutiny (definitive diagnosis). While basic techniques are required for visualization of the basic cross section, advanced techniques are required for that of the aortic arch. Moreover, there are no clear criteria to distinguish normal and abnormal from the basic cross section. In particular, screening requires some judgment criteria. CHD can be complicated by chromosomal abnormalities and exocardiac disorders. The diagnostic accuracy can be improved by evaluating exocardiac disorders. Last, the scrutiny of basic cross sections has some pitfalls into which we may fall. For this reason, ventricular septal defects and so on tend to give false positives. This paper clarifies the range to be checked by the current diagnostic method and provides some tips to improve the detection rate by making additions to the established methodology.