New Indicators in Fetal Echocardiology

Abstract

In Japan, there has recently been a marked increase in fetal heart diagnosis concomitant with an overall increase in the diagnosis of prenatal diseases. With advances in imaging technology, congenital heart disease, which previously was difficult to diagnose in the fetus, can now be successfully diagnosed prenatally. Furthermore, it is now possible to evaluate cardiac function and predict prognosis after birth. In this article, I identify new indicators in fetal echocardiography and provide comprehensive yet concise commentaries as follows: (i) cardiac function assessment by tissue Doppler imaging (TDI), myocardial performance (Tei) index, and cardiovascular profile score (CVPS); (ii) anatomical diagnosis by I-shaped sign, post LA space index (PLAS index), and U-sign; and (iii) prediction of the status and prognosis after birth by assessment of pulmonary venous flow pattern and pulsatility index (PI) during maternal hyperoxygenation testing in hypoplastic left heart syndrome, foramen ovale, and the ductus arteriosus in transposition of great arteries.