Fetal echocardiographic assessment: impact of gestational age and
maternal obesity.
Abstract
Introduction: To identify the ability to acquire various fetal cardiac
views using two-dimensional ultrasound at different gestational age and
body mass index (BMI) categories. Material and methods: We performed a
prospective observational study among low-risk women with singleton
pregnancies attending the University Obstetrics Unit, North Colombo
Teaching Hospital, Ragama, Sri Lanka. The ability to obtain satisfactory
views for the situs, four chambers (4CH), right and left outflow tracts
(ROFT/LOFT), three vessels (3V), aortic arch (AA), ductal arch (DA), and
superior and inferior vena cava (SVC/IVC) of fetal heart was studied.
Results: A total of 314 eligible pregnant women underwent fetal
echocardiography and 288 had complete data. All eight cardiac views were
obtained with a 100% success at the gestational age of 18 to 21+6
weeks. All eight cardiac views were satisfactory in more than 97% at
the gestational age of 22 to 25+ 6 weeks. BMI was not significantly
associated with acquisition of cardiac views at all gestations (Log-rank
test, p=0.62). All eight cardiac views were obtained with 50% success
at 14 -17+6 weeks and 5.4% success at 11-13+6 weeks. Conclusions: The
ability to acquire all fetal cardiac views was best at 18 to 21+6 weeks
of gestation, but reasonably successful till 26 weeks. The acquisition
of all cardiac views was sub-optimal in early gestations below 18 weeks
and for some of the cardiac views after 26 weeks. BMI does not hamper
the ability to obtain cardiac views during fetal echocardiography.