First and early second trimester fetal heart screening

Purpose of review This review describes the recent advances in timing and effectiveness of first and early second trimester fetal echocardiography screening. Recent findings Fetal echocardiography can now be reliably performed from 11 weeks' gestation owing to improvements in ultrasound transducers and processors. Three-dimensional, and four-dimensional ultrasound modalities in image acquisition and postprocessing analysis, including spatio-temporal image correlation, rendering three-dimensional power Doppler and high definition power flow Doppler, and B-flow have further improved our capabilities in this area. Fetal nuchal translucency measurement screening programs, create a new population of at-risk pregnancies that will be-referred for early fetal echocardiography. The,majority Of congenital heart,defects, however, still occur in low-risk patients. Improved technology has lowered the gestational age at which fetal cardiac anatomy scanning can be reliably performed,by properly trained and experienced examiners. Summary Early fetal echocardiography can be offered as a screening examination to at-risk and low-risk patients', with the proviso that it be repeated following screen-negative scans at mid-gestation to exclude later developing lesions.