Evaluation of fetal heart geometry during pregnancy by three-dimensional ultrasound using the STIC rendering mode.

OBJECTIVE: To determine fetal heart geometry during pregnancy using three-dimensional (3D) ultrasound and the spatiotemporal image correlation (STIC) rendering mode. METHODS: This prospective, cross-sectional study evaluated 250 normal singleton pregnancies from 20 to 33 weeks and 6 days of gestation. STIC rendering was used to calculate the eight angles of the fetal heart: apex, base, mitral valve, tricuspid valve, left ventricle, right ventricle, left atrium, and right atrium angles. The concordance correlation coefficient (CCC) was used for intra- and inter-observer tests. RESULTS: The average ± SD maternal age was 31.7 ± 4.9 years, and the average gestational age was 26.3 ± 4.2 weeks. There was little variation in fetal heart angles using STIC rendering according to the gestational age, with determination coefficient (R2 ) values of 0.01 for the apex and mitral valve angles and <0.01 for the base, tricuspid valve, left ventricle, right ventricle, left atrium, and right atrium angles. Moderate/good intra- and inter-observer concordance was observed for the measurement of fetal heart angles using STIC rendering, and the obtained CCC varied from 0.74 to 0.93. CONCLUSION: The fetal heart geometry did not present significant variations during pregnancy using 3D ultrasound and the STIC rendering mode.

Anatomically corrected malposition of the great arteries: a challenging fetal diagnosis.

Anatomically corrected malposed great arteries are uncommon and benign entity. Basically, this occurs with ventriculoarterial concordance in which the great vessels arise parallel instead of a twisting fashion. In this manuscript, we described two cases in which the antenatal diagnosis of anatomically corrected malposition of great arteries was suspected and confirmed during the postnatal period. During the fetal life, this diagnosis remains a challenge and this condition is often misdiagnosed as the transposition of the great arteries (TGA). Differently to TGA, anatomically corrected malposition of the great arteries may not require any cardiac surgical intervention depending on the associated cardiac anomalies. Indeed, postnatal examination for concerns related to anomalies that can be associated with this condition, such as anomalous origins of coronary arteries and left ventricular outflow tract obstruction, should be performed.