Possibilities of prenatal diagnostics of severe congenital heart disease

New high resolution real-time cross-sectional ultrasound imaging systems enabled us to evaluate normal fetal cardiac anatomy in detail. Over a period of 2 years 119 fetuses were imaged successfully and reexamined after birth. The estimated fetal age varied from 20 - 41 weeks (mean 32 ± 0.5 S.E. weeks) of pregnancy. The estimated fetal weight varied from 500-3150 grams (mean 1610 ± 85 S.E. grams). To document fetal cardiac anatomy, we reproduced commonly used cross-sectional views of the heart. Most useful for cardiac evaluation have been the four-chamber view and the short axis great vessel orientation views, which could be obtained in 96% and 91% of the patients respectively. Cardiac structures such as ventricullar walls, ventricular and atrial septae, AV-valves, foramen ovale, four-chambers as well as two great arteries with a spiral relationship (in 91%) could always be imaged in detail satisfactorily. The examination was extended to the aortic arch and a descendens (88% visualized) as well as to the v. cavae (86% visualized). Having examined all fetuses after birth, we can verify that we have not missed any cardiac malformation. A coarctation of the aorta was detected recently.