ADVANCES IN FETAL ECHOCARDIOGRAPHY

Fetal echocardiography is the primary modality for defining and evalua ting fetal cardiac status and requires detailed analysis of the cardia c anatomy from numerous views and Doppler interrogation of the intraca rdiac structures great vessels, and umbilical artery. Referrals for fe tal echocardiography are determined by fetal, maternal, or familial ri sk factors; however, approximately 50% of neonates diagnosed with a co ngenital cardiac defect have no risk factor and most have undergone an obstetrical ultrasound during the pregnancy that did not detect a car diac defect. Advances in transducer technology have resulted in the de velopment of small high-frequency transvaginal probes that allow fetal cardiac interrogation earlier during gestation. On the horizon is 3-d imensional fetal echocardiography, which provides rapid image acquisit ion and tremendous computer image reconstruction ability. At present, the computer image data analysis process is lengthy and several techni cal limitations must be overcome before 3-dimensional fetal echocardio graphy becomes the primary modality of fetal cardiac imaging. New Dopp ler Tissue Imaging(TM) using color Doppler energy mapping allows more precise anatomic definition of the fetal endocardium, facilitating dia gnosis of small Ventricular septal defects. These new advances, along with improved image resolution, provide obstetricians and pediatric ca rdiologists with more tools and techniques for earlier and more precis e detection of fetuses with cardiac defects.