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. 2019 Jun 6;112(5):600-648.
doi: 10.5935/abc.20190075.

Brazilian Fetal Cardiology Guidelines - 2019

[Article in English, Portuguese]
Simone R F Fontes Pedra  1   2 , Paulo Zielinsky  3 , Cristiane Nogueira Binotto  4   5 , Cristiane Nunes Martins  6 , Eduardo Sérgio Valério Borges da Fonseca  7 , Isabel Cristina Britto Guimarães  8   9 , Izabele Vian da Silveira Corrêa  3 , Karla Luiza Matos Pedrosa  9 , Lilian Maria Lopes  10 , Luiz Henrique Soares Nicoloso  3 , Marcia Ferreira Alves Barberato  11 , Marina Maccagnano Zamith  12
Affiliations

Brazilian Fetal Cardiology Guidelines - 2019

[Article in English, Portuguese]
Simone R F Fontes Pedra et al. Arq Bras Cardiol. .
No abstract available

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Figures

Figure 2.1
Figure 2.1
Standardization of fetal heart screening, scanning the fetal vessels and heart from the infradiaphragmatic region towards the cranium. There are 6 levels, being the first exactly below the diaphragm, which allows the identification of the descending aorta and inferior vena cava; second, the four-chamber view; third, left ventricular outflow tract; fourth, right ventricular outflow tract; fifth, three vessel view, and, sixth, three vessel and trachea view. Ao: Aorta; AoA: aortic arch; Asc: ascending; DA: ductus arteriosus; IVC: inferior vena cava; LA: left atrium; LV: left ventricle; PA: pulmonary artery; RA: right atrium; RV: right ventricle; RVOT: right ventricular outflow tract; S: stomach; Sp: spine; SVC: superior vena cava; T: trachea.
Figure 2.2
Figure 2.2
Aorta and pulmonary artery appear elongated, going toward the descending aorta. Both converge to the aorta forming an image similar to a V letter. The trachea is to the right of the aortic arch, demonstrating that the latter descends to the left. During color flow mapping, both arches are observed to have flow in the same direction, i.e., from the heart toward the descending thoracic aorta. AoA: aortic arch; DA: ductal arch; SVC: superior vena cava; T: trachea.
Figure 2.3
Figure 2.3
Long axis view of the aortic arch. The shape of the aortic arch is similar to a cane.
Figure 2.4
Figure 2.4
Longitudinal plane slightly anterior and to the left of the fetus, showing the long axis view of the ductal arch. The ductal arch has a different angle than the aortic and looks like a golf club. LPA: left pulmonary artery; PA: pulmonary artery.
Figure 2.5
Figure 2.5
Longitudinal fetal plane tilting posteriorly, showing the bicaval view. IVC: inferior vena cava; RA: right atrium; SVC: superior vena cava.
Figure 2.6
Figure 2.6
Short-axis of the ventricles. In this plane it is possible to analyze the position of the papillary muscles of the right and left ventricles. It is also of great utility in detecting subtler forms of atrioventricular septal defect when it is presented with two valvular orifices. A: anterior; P: posterior; LV: left ventricle; RV: right ventricle; S: stomach.
Figure 2.7
Figure 2.7
Short axis view of the great vessels. This plane shows the relationship between the great arteries, with the aorta being in the center of the heart and posteriorly and the right ventricular outflow tract surrounding the aorta anteriorly. This is an excellent plane for identifying perimembranous ventricular septal defects and pulmonary obstructions due to the anterior deviation of the infundibular septum observed in the tetralogy of Fallot. Ao: aorta; DAo: descending aorta; LPA: left pulmonary artery; PA: pulmonary artery; RPA: right pulmonary artery; RV: right ventricle.
Figure 3.1
Figure 3.1
Fetal care flowchart according to the specific fetal heart condition. USG: ultrasound.
Figure 6.1
Figure 6.1
Food pyramid.
Figure 6.2
Figure 6.2
Recommendations for fetal ductal constriction treatment during the third gestational trimester. In cases in which there is no reversal of the ductal constriction and its consequences after initiation of treatment, preterm delivery may be considered, since fetal pulmonary maturity has been established. Class of recommendation: IIb; Level of evidence: C.
Figure 6.3
Figure 6.3
Recommendations for fetal ductal constriction prevention during the third gestational trimester.
Figure 7.1
Figure 7.1
Suggested approach for pregnant women with positive antibodies, without fetal CAVB. CAVB: complete atrioventricular block; ms: miliseconds.
Figure 7.2
Figure 7.2
Suggested approach for fetuses who have CAVB. CAVB: complete atrioventricular block; HR: heart rate.
Figure 7.3
Figure 7.3
Sinus tachycardia clinical management.
Figure 7.4
Figure 7.4
Treatment flowchart for ventricular tachycardia. IV: intravenous; PO: orally.
Figure 7.5
Figure 7.5
Flowchart treatment for supraventricular tachycardias. ECV: electric cardioversion; IV: intravenous; PO: orally.
See this image and copyright information in PMC

References

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