First-trimester screening for congenital heart disease

Abstract

Advances over the last decade in technology, training, and availability of prenatal care have led to a focus on the detection of congenital heart defects (CHD) and its prenatal management for improved pregnancy outcomes. First-trimester transvaginal heart screening is feasible and well tolerated. Due to advances in the diagnosis of trisomy by nonultrasound methods, a significant effort will now be focused on CHD detection in the first trimester of otherwise uncomplicated pregnancies.

Purpose of review: Detection of CHD is not being accomplished by heart screening training or postnatal protocols. First-trimester evaluation of fetuses is becoming more common, and a method of evaluation of the heart would improve selection of those who need later fetal echocardiography.

Recent findings: Equipment advances are resulting in excellent visualization of the fetal circulatory system even at 12–13 weeks, gestation.

Summary: Improved first-trimester fetal heart screening will result in a jump in CHD detection and in improved care of these patients during gestation and prior to their cardiac surgery.