Evaluation of normal and abnormal fetal heart anatomy using 3D echocardiography

We applied 3D echocardiography to the diagnosis or exclusion of congenital heart disease (CHD) using rate gating with Doppler. Gated 3D volume data sets enabled diagnostically acceptable visualization of all cardiac structures in 16 of 29 fetuses without CHD and in 7 of 22 fetuses with CHD, and significant elements of anatomy in the remainder. In fetuses without CHD a dynamic 3D perspective of valve morphology and ventricular wall motion of the four- and five-chamber view projection was available in 19/29 cases. A high quality 3D reconstruction of the site and spatial orientation of VSD could be obtained in 9/13 patients with CHD. The 2D imaging remained the principal diagnostic modality in all cases with additonal structural detail obtained by 3D imaging in only two fetuses with CHD. The 3D imaging of the fetal heart is feasible and may provide additional information of clinical value in a small number of cases with CHD when compared with 2D imaging.