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Increasing the Detection Rate of Normal Fetal Cardiac Structures: A Real-Time Approach

Mohawk-McMaster Institute for Applied Health Sciences, Hamilton, Ontario, Canada, ted.scott{at}mohawkcollege.ca

Hans Swan, PHD

Charles Sturt University, Wagga Wagga, NSW, Australia

Gerald Moran, PHD

McMaster University, Hamilton, Ontario, Canada

Tapas Mondal, MD

McMaster Children's Hospital, Hamilton, Ontario, Canada

Judy Jones, BSC, RDMS, RDCS

London Health Sciences, London, Ontario, Canada

Karm Guram, MD

McMaster University, Hamilton, Ontario, Canada

Jaime Huff, BSC, RDCS

London Health Sciences, London, Ontario, Canada

The purpose of this study was to determine if acquiring real-time sweeps of the fetal heart would be a more effective method of identifying normal cardiac structures compared with using static images during routine second-trimester obstetric sonograms. Subjects were scanned using three different techniques. The static image acquisition (protocol A) included three images of the fetal heart. Protocol B used two gray-scale sweeps through the fetal heart. Protocol C acquired three color loops of the fetal heart. The sweeps demonstrated a complete normal cardiac assessment in 71% of studies, compared with the static image and color Doppler techniques that completed a normal cardiac assessment in only 39% of studies, respectively. The real-time technique detected four chambers, the left ventricular outflow tract (LVOT), the right ventricular outflow tract (RVOT), the LVOT/RVOT crossover, and size and axis of the heart with a greater frequency than the static images and color loops in all cases. In addition, the real-time technique was able to demonstrate the pulmonary veins in 56% of cases compared with 3.6% for static images. The color Doppler acquisition demonstrated blood flow through the atrial-ventricular and semilunar valves in 86% of cases.

Key Words: sonography • fetal heart • real-time • static • detection • tissue harmonic

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