Clinical scope of early fetal echocardiography

Abstract

The chances of detecting congenital heart disease are improved following structured protocols. Fetal heart disease is one of the main serious congenital malformations. The objective of this review is to present the benefits of sequential and routine cardiac evaluation in the first and early second trimesters and to identify the structures and pathologies that can be detected at this gestational age. The databases of PubMed, Medline, MD consult, Embase, Clinical Key, Scielo, and ScienceDirect, as well as specialized texts in Spanish and English were searched for diagnostic studies, systematic reviews, and meta-analysis related to the terms “early fetal echocardiography” and “congenital heart malformations” published between 2000 and 2019. Technological advances have revolutionized the fetal echocardiographic examination making possible the diagnosis of congenital heart disease from the first and early second trimester of pregnancy. However, it should be recognized that early fetal echocardiography has limitations such as the evaluation of pulmonary veins and cardiac lesions that are progressive. The benefit found was earlier detection of pathologies with high sensitivity and specificity. A fetal cardiac evaluation sequence was included in these early fetal echocardiographic examinations due to the awareness of fetal anatomical and hemodynamic differences in the first trimester and the beginning of the second trimester. Early fetal echocardiography is a very useful tool for the detection of congenital heart disease; it allows parents to be informed about the prognosis and possible treatments early. Fetal cardiac examination in the first trimester is safe and can detect the most of heart congenital malformation.