Ultrasound evaluation of fetal cardiac development and hemodynamics

Purpose To evaluate and describe fetal cardiac development and hemodynamics high risk pregnancy by using ultrasound technique. Methods Two hundred and thirty three pregnancies were prospectively studied by using the detailed fetal echocardiographic procedure(fetus gestational age from 19 weeks to 39 weeks).Cardiac chamber size,internal diameter of great arteries were documented together with the presence of inflow and outflow wave patterns.In utero diagnoses of variety of congenital heart defects were also conducted. Results Cardiac chamber size and internal diameter of great arteries showed a positive correlation with the increasing of gestational age.Left and right ventricles were demonstrated the same size during whole fetal observational period.Blood flow through mitral valve and tricuspid valve were typically ‘M’ type.By comparing ‘e’ wave and ‘a’ wave,this inflow blood velocity pattern was dominant by `a' wave,though the ratio of a/e gradually decreased during the fetal development period.Blood velocity in aorta and pulmonary artery remained steady along with the gestational age.The detection rate of verity types of congenital heart diseases in this sample population was 5.7%(13 cases),the major problem was the complex heart malformation.The occurrence of fetal cardiac arrhythmia was 14 cases(16%),with the majority of atrial premature beat. Conclusions Fetal echocardiography can be used to evaluate and monitor the change of cardiac anatomy,structure and hemodymanics during the different gestational age.This has provided a new approach to the further understanding of fetal cardiac development,and is important to the screening of congenital heart disease during pregnancy.