3/30/2023 0 Comments Heart sonogramThe left atrium and descending aorta are nearest to the spine and the cardiac axis points to the left.Ħ. Obtain a 4 chamber view of the heart by obtaining a transverse view of the thorax. Obtain a transverse view of the abdomen and define the fetal stomach, which is positioned in the left side of the abdomen.ĥ. With respect to the left uterine wall, the fetal left side will be on the maternal left.Ĥ. With respect to the right uterine wall, the fetal left side will be on the maternal right.ĭ. With respect to the posterior uterine wall, the fetal left side is posterior and farthest from the transducer.Ĭ. With respect to the maternal abdomen, the fetal left side is anterior and near to the ultrasound transducer.ī. Determine the position of the fetal left side.Ī. When the fetal spine is perpendicular to the maternal spine, the fetus is in transverse lie.ģ. In the sagittal view, if the fetal and maternal spine are parallel, the fetus is in longitudinal lie. Determine whether the fetal spine is parallel or transverse to the maternal spine. Define within the uterus the presentation of the fetus (generally, vertex or breech).Ģ. The fetal stomach is normally on the left side, the left atrium is nearest to the fetal spine, and the cardiac axis points to the left.ġ. Situs solitus describes the normal position of fetal organs. The trachea is not well seen in this view.ĭetermine fetal viability by either M-mode or by direct visualization of fetal cardiac activity. Slightly oblique transverse view of the chest demonstrating the 3 vessel view in the appropriate order: the MPA (main pulmonary artery), the aorta, and the SVC (superior vena cava). In addition, the vascular patterns for many of the defects are presented.Ībove. Using this approach, a sensitivity of 88.5% and a specificity of 100% for the detection of CHDs at 11 to 13 weeks was achieved. The transducer assessed ventricular inflows in color at the level of the 4 chamber view, the 3 vessel view and finally demonstrating the V sign at the level of the 3 vessel trachea view. The ideal insonation beam was 45 degrees with the fetal spine at 6 o’clock. The most effective approach was color mapping of the 4 chamber and 3 vessel and trachea views. In this prospective observational study performed at 11 to 13 weeks, among 1084 patients, 35 cases were confirmed to have a congenital heart defect. “Prenatal detection of congenital heart defects at the 11-to-13 week scan using a simple color Doppler protocol including the 4-chamber and 3-vessel and trachea views” : Use a higher megahertz transducer prior to application of color Doppler.Ī summary of the key axial views of the heart will be presented as recommended by the ISUOG guidelines followed by a more detailed description of fetal cardiac views and their significance.Ībove images courtesy of Jill Beithon, RT, RDMS, RDCS, RVT. The cardiac image should occupy approximately 1/3 to 1/2 of the ultrasound screen. Use magnification or “zoom” to increase the frame rate and obtain cine loops and video clips to define anatomic details. Use the highest frequency transducer, adjust the overall gain, correct depth, adjust sector width, decrease the compression or dynamic range, and adjust the focal zone. This topic summarizes a stepwise approach to the ultrasound anatomy of the fetal heart.Īlways follow the ALARA principle to use “as low as is reasonably achievable” to obtain satisfactory images. To assess fetal cardiac anatomy, a disciplined approach is necessary and optimization of the 2-D equipment is necessary prior to application of color Doppler. The aim of the screening exam is to define normality and whether there is deviation from normality, requiring referral for fetal echocardiogram. In addition, the transverse view of abdomen, the 3 vessel view (3VV), and the 3 vessel tracheal (3VT) view are recommended by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). All major specialty organizations, including the American Institute for Ultrasound in Medicine (AIUM), recommend the four chamber, the left ventricular outflow tract (LVOT), and the right ventricular outflow tract (RVOT) views. The cardiac screening exam is one of the most important aspects of fetal assessment since congenital heart defects are a major cause of mortality and prenatal detection can improve outcomes. Page Links: Overview Aims, Fetal Heart Assessment: Gray Scale, 2-D Optimization, Screening Cardiac Exam, 11-13 Week Scan, Videos, Fetal Viabilty, Fetal Situs, Four Chamber View, Interventricular Septum, Atrial Views, Pulmonary Veins, Left Ventricular Outflow Tract (LVOT), Right Ventricular Outflow Tracts (RVOT), Three Vessel View (3 VV), Three Vessel Tracheal View (3VT), Aortic Arch, Ductal Arch, Color Doppler, References
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