Abstract
Purpose
The earlier the detection and diagnosis of congenital heart diseases (CHD), the greater the clinical benefit; however, early fetal cardiac examination can be a challenge.
The aim of our study is to demonstrate that the fetal cardiac examination at 13+0–13+6 weeks can be as adequately assessed as the examination performed at 16 weeks in patients with low and high body mass index (BMI).
Methods
The study was a prospective observational cohort study. One hundred pregnant women at low risk of congenital heart anomalies were divided into two groups: 49 women with low BMI (<25) and 51 women with high BMI (≥ 25).
A complete fetal cardiac scan was performed on each patient at 13+0–13+6 weeks, via the transvaginal and transabdominal approaches, and at 16 weeks by the transabdominal approach.
Results
The examination at 13+0–13+6 weeks was adequately assessed in at least one of the two routes in 97 patients, as opposed to 87 patients at 16 weeks. A significantly higher adequate assessment rate was obtained at 13+0–13+6 weeks than at 16 weeks (p=0.017).
The transvaginal approach showed the best resolution of the three examinations in 42% of women with BMI ≥35. No CHD were overlooked.
Conclusions
Early fetal echocardiography is feasible and accurate at 13+0–13+6 weeks. Within patients with high BMI, early fetal echocardiography may be performed two weeks in advance, since it allows visualization of the fetal heart through the transvaginal route with a higher resolution in a large number of women, which is not feasible at 16 weeks.
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Data Availability
The anonymized data that support the findings of this study are available from the corresponding author upon reasonable request.
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Study conception and design: R García Delgado, JA García. Material preparation: R García Rodríguez., M Medina. Sonographer: R García Delgado. Data collection and analysis were performed by R García Delgado, R García Rodríguez, I Ortega, M de Luis, and J Segura. Statistical analysis of the data: JM González. The first draft of the manuscript was written by R García Delgado and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the Ethics and Research Committee of the Complejo Hospitalario Universitario Insular Materno Infantil. (CEIC-CHUIMI-2015/819). Informed consent was obtained from all individual participants included in the study.
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Patients signed informed consent regarding publishing their data and ultrasound images.
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The authors declare no competing interests.
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García Delgado, R., García Rodríguez, R., Ortega Cárdenes, I. et al. Feasibility and Accuracy of Early Fetal Echocardiography Performed at 13+0–13+6 Weeks in a Population with Low and High Body Mass Index: a Prospective Study. Reprod. Sci. 28, 2270–2277 (2021). https://doi.org/10.1007/s43032-021-00477-7
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DOI: https://doi.org/10.1007/s43032-021-00477-7