Collaborative Study of 4‐Dimensional Fetal Echocardiography in the First Trimester of Pregnancy

• Published in: Journal of ultrasound in medicine Vol. 33; no. 6; pp. 1079 - 1084
• Main Authors: Espinoza, Jimmy, Lee, Wesley, Viñals, Fernando, Martinez, Josep Maria, Bennasar, Mar, Rizzo, Giuseppe, Belfort, Michael
• Format: Journal Article
• Language: English
• Published: England American Institute of Ultrasound in Medicine 01-06-2014
• Subjects: 4-dimensional sonography; congenital heart defects; Cooperative Behavior; echocardiography; Echocardiography, Four-Dimensional - methods; Female; fetal; first trimester; Heart Defects, Congenital - diagnostic imaging; Heart Defects, Congenital - embryology; Humans; Interinstitutional Relations; Italy; Male; Observer Variation; obstetric ultrasound; Pregnancy; Pregnancy Trimester, First; prenatal diagnosis, spatiotemporal image correlation; Reproducibility of Results; Sensitivity and Specificity; Telemedicine - methods; Ultrasonography, Prenatal - methods; United States; prenatal diagnosis, spatiotemporal image correlation; first trimester; echocardiography; 4-dimensional sonography; fetal; obstetric ultrasound; congenital heart defects
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/ultra.33.6.1079

Objectives
Accumulating evidence supports a role for 2‐dimensional fetal echocardiography in the first trimester of pregnancy for the identification of congenital heart defects. Our objective was to investigate the role of 4‐dimensional (4D) sonography in the identification of congenital heart defects between 11 and 15 weeks of pregnancy.
Methods
This study included 4 centers with expertise in first‐trimester 4D fetal echocardiography. Fetuses with and without confirmed heart defects were evaluated between 11 and 15 weeks and their volume data sets were uploaded onto a centralized file transfer protocol server.
Results
Forty‐eight volume data sets from fetuses with normal (n = 17) and abnormal (n = 16) hearts were evaluated. Overall, the median (range) accuracy, sensitivity, and specificity, as well as the positive and negative likelihood ratios, for the identification of fetuses with congenital heart defects were 79% (77%–83%), 90% (70%–96%), 59% (58%–93%), 2.35 (2.05–9.80), and 0.18 (0.08–0.32), respectively.
Conclusions
(1) Four‐dimensional fetal echocardiography can be performed in the first and early second trimesters of pregnancy; and (2) 4D volume data sets obtained from fetuses between 11 and 15 weeks can be remotely acquired and accurately interpreted by different centers.