Echocardiography in the human fetus

The objectives of this study were as follows. The first objective was to assess and review current non-invasive methods of studying normal and abnormal human fetal cardiac morphology and function. A discussion of the four currently used ultrasonic techniques to define fetal cardiac anatomy and physiology can be found in chapter 2. The second objective consisted of the analysis of results obtained following examination of a group of patients deemed at increased risk of producing a child with congenital heart disease. The data from a group of 1577 pregnant women are presented in chapter 3. Patients with certain complications of pregnancy are also considered to be at risk of carrying a child with congenital heart disease, either alone or in combination with other structural or chromosomal aberrations. The third objective, therefore, was to analyse 440 patients collected in this category. The data can be found in chapter 4. The fourth objective was to establish and, therefore, understand possible pitfalls and errors when assessing fetal cardiac anatomy ultrasonically. To this end an ultrasonic-pathologic correlation was made wherever possible. The appropriate correlations in 12 cases are presented in chapter 5. Fetal cardiac arrhythmia may be entirely benign or life threatening. It is imperative to correctly define the type of arrhythmia and its possible association with congenital heart disease before a realistic prognosis can be given or before considering therapeutic options. The objective of chapter 6 was to describe methods of recording and definition of fetal cardiac arrhythmia and to assess the outcome in this group.

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