Fetal Echocardiography in the Second Trimester of Pregnancy

Fetal heart is one of the most difficult organs to examine during second trimester fetal ultrasound. Conventional two-dimensional screening ultrasound using a four-chamber view alone allows detection of 5%-60% of congenital cardiac defects. If ventricular outflows are included in routine screening protocol, the detection rate of major cardiac disease is significantly increased to 85,5%-90%. Therefore ISUOG (International Society of Ultrasound Obstetrics and Gynecology) state that the left and right ventricular outflows should be included in the "Optimal Examination" of the fetus. Another important issue is that fetal echocardiography when combined with first and/or second trimester screening for trisomy 21 may increase the detection rate to almost 94%. This may be advantageous for patients who desire a highest sensitivity before considering invasive testing.