Changes in fetal cardiac axis between 8 and 15 weeks' gestation. (6th November 2013)

• Record Type: Journal Article
• Authors: McBrien, A.; Howley, L.; Yamamoto, Y.; Hutchinson, D.; Hirose, A.; Sekar, P.; Jain, V.; Motan, T.; Trines, J.; Savard, W.; Hornberger, L. K.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 42:Number 6(2013:Dec.)
• Page Start: 653
• Page End: 658
• Publication Date: 2013-11-06
• Subjects: Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.12478
• Languages: English
• ISSNs: 0960-7692

Abstract

<abstract abstract-type="main" id="uog12478-abs-0001"> <title>ABSTRACT</title> <sec id="uog12478-sec-0001" sec-type="section"> <title>Objectives</title> <p id="uog12478-para-0001"> <italic>To document changes in the normal embryonic/fetal cardiac axis in the late first and early second trimesters of pregnancy</italic>.</p> </sec> <sec id="uog12478-sec-0002" sec-type="section"> <title>Methods</title> <p id="uog12478-para-0002"> <italic>Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks' gestation in 166 healthy pregnancies and in 10 pregnancies with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four‐chamber view. Differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies were compared</italic>.</p> </sec> <sec id="uog12478-sec-0003" sec-type="section"> <title>Results</title> <p id="uog12478-para-0003"> <italic>The mean ± SD embryonic/fetal cardiac axis was 25.5 ± 11.5° from 8 + 0 to 9 + 6 weeks (Group 1), 40.4 ± 9.2° from 10 + 0 to 11 + 6 weeks (Group 2), 49.2 ± 7.4° from 12 + 0 to 12 + 6 weeks (Group 3), 50.6 ± 5.7° from 13 + 0 to 13 + 6 weeks (Group 4) and 48.6 ± 7.3° from 14 + 0 to 14 + 6 weeks (Group 5). Groups 1 and 2 were significantly different from each other and all other groups (</italic>P < <italic>0.05). The results for 22 cases with repeat measurements from 8 + 0 to 11 + 6 and 12 + 0 to 14 + 6 weeks confirmed that the embryonic/fetal cardiac axis increased significantly (</italic>P < <italic>0.001). In the cases with severe congenital heart disease, the cardiac axis was > 90<sup>th</sup> centile in four cases and < 10<sup>th</sup> centile in two cases</italic>.</p> </sec> <sec id="uog12478-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="uog12478-para-0004"> <italic>The embryonic cardiac axis is relatively midline at 8 weeks and levorotates in the late first trimester. By 12 weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14 + 6 weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15 weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd</italic>.</p> </sec> </abstract>