Pediatric Cardiology

, Volume 25, Issue 3, pp 223–233 | Cite as

Technique of Fetal Echocardiography

  • L. Allan


The fetal heart is examined by a series of sequential ultrasound views, which image the cardiac connections and intracardiac structure. The imformation obtained by cross-sectional imaging can be augmented by the use of cardiac measurements, and evaluation with pulsed or color flow Doppler. A thorough familiarity with the normal appearance and systematic evaluation of standard views can exclude or diagnose major heart malformations. With training, cardiac evaluation can be performed during routine obstetric scanning, in a matter of minutes. An accurate description of any abnormal findings and a knowledge of the types of cardiac malformation which are possible, will help the examiner to reach a correct diagnosis.


Fetal heart Fetal echocardiography Congenital heart disease Prenatal diagnosis 

Supplementary material

The ultrasound beam is swept up from the abdomen to the four-chamber view. The stomach and apex are on the same side of the fetus. The correct relationship of the aorta and inferior vena cava in the abdomen can be noted. The apical four-chamber view imaged here allows all the features that need to be checked in the normal four-chamber view to be seen.
The four-chamber view is seen in a lateral projection in which the fetus lies with the right anterior chest closest to the transducer. The ultrasound beam is perpendicular to the ventricular septum. All the normal features of a four-chamber view can be checked in this orientation, although the appearance of the four-chamber view is slightly different from the apical projection.
The ultrasound beam is swept up the front of the chest from the four-chamber view to image the left and right outflow tracts and transverse arch sequentially. The size and positional relationships of the great arteries can be checked. The normal crossover of the pulmonary artery over the aorta is demonstrated.
The transverse view of the duct and transverse arch are seen simultaneously on color-flow mapping. The longer vessel arising from near the front of the chest and directed straight back toward the spine is the pulmonary artery with its continuation as the arterial duct. The aorta arises in the middle of the thorax, forms the transverse arch on the right side of the pulmonary artery and duct, and crosses the midline to join the duct just to the left of the spine. In the normal fetus as shown here, these vessels should be of similar size and flow should be in the same direction within them.
The ductal and aortic arches are seen in the long axis of the fetus in slightly different planes of section. The transducer beam can be swept from the duct at the start of the clip to the aortic arch at the end. The normal size and positional arrangements of the great arteries can be noted.


  1. 1.
    Allan, LD 2000The normal fetal heart.Allan, LDHornberger, LSharland, G eds. Fetal Cardiology.Greenwich MedicalLondon4560Google Scholar
  2. 2.
    Allan, LD, Crawford, DC, Chita, SK, Tynan, MJ 1986Prenatal screening for congenital heart disease.Br Med J29217171719Google Scholar
  3. 3.
    Allan, LD, Santos, R, Pexieder, T 1997Anatomical and echocardiographic correlates of normal cardiac morphology in the late first trimester fetus.Heart776872PubMedGoogle Scholar
  4. 4.
    Allan, LD, Tynan, MJ, Campbell, S, Wilkinson, J, Anderson, RH 1980Echocardiographic and anatomical correlates in the fetus.Br Heart J44444451PubMedGoogle Scholar
  5. 5.
    Cordes, TM, O’Leary, PW, Seward, JB, Hagler, DJ 1994Distinguishing right from left: a standardized technique for fetal echocardiography.J Am Soc Echocardiogr74753PubMedGoogle Scholar
  6. 6.
    Huggon, IC, Ghi, T, Cook, AC,  et al. 2002Fetal cardiac abnormalities identified prior to 14 weeks gestation.Ultrasound Obstet Gynecol202227CrossRefPubMedGoogle Scholar
  7. 7.
    Kleinman, CS, Hobbins, JC, Jaffe, CC,  et al. 1980Echocardiographic studies of the human fetus: prenatal diagnosis of congenital heart disease and cardiac dysrhythmias.Pediatrics6510591064PubMedGoogle Scholar
  8. 8.
    Lange, LW, Sahn, DJ, Allen, HD,  et al. 1980Qualitative real-time cross-sectional echocardiographic imaging of the human fetus during the second half of pregnancy.Circulation62799806PubMedGoogle Scholar
  9. 9.
    Sahn, DJ, Lange, LW, Allen, HD,  et al. 1980Quantitative real-time cross-sectional echocardiography in the developing human fetus and newborn.Circulation62588PubMedGoogle Scholar
  10. 10.
    Sharland, GK, Allan, LD 1992Normal fetal cardiac measurements derived by cross-sectional echocardiography.Ultrasound Obstet Gynecol2175181CrossRefPubMedGoogle Scholar
  11. 11.
    Tan, J, Silverman, NH, Hoffman, JIE, Villegas, M, Schmidt, KG 1992Cardiac dimensions determined by cross-sectional echocardiography in the normal human fetus from 18 weeks to term.Am J Cardiol7014591467CrossRefPubMedGoogle Scholar
  12. 12.
    Yoo, SJ, Lee, YH, Kim, ES,  et al. 1997Three-vessel view of the fetal upper mediastinum: an easy means of detecting abnormalities of the ventricular outflow tracts, and great arteries during obstetric screening.Ultrasound Obstet Gynecol9173182CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • L. Allan
    • 1
  1. 1.King’s College Hospital, LondonUnited Kingdom

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