Normal fetal cardiac morphometric parameters reference across gestation

Background Congenital heart disease (CHD) is a serious life-threatening medical condition in newborns with high rates of mortality. It is responsible for around fifty percent of total childhood deaths caused by birth defects so establishing the references for fetal normal cardiac morphometric parameters during various gestational ages is essential. Objective The aim of the current study was to propose standardized references with Z-scores for fetal normal heart dimensions, main pulmonary artery (PA) and aorta (Ao) diameters as well as the PA/Ao ratio across gestation in the Egyptian population to boost the detection rate of CHD before birth since early diagnosis of CHD has shown remarkably better outcomes. Results Standard references were established for twenty-one fetal normal cardiac morphometric measurements including PA and Ao diameters, PA/Ao ratio by the three-vessel view in addition to cardiac dimensions of the heart and each chamber separately as well as myocardial wall thicknesses by the four-chamber view. All estimated measurements showed a progressive increase throughout different gestational ages. Both sides of the heart were nearly equal in size at early weeks of gestation; however with the advance of gestation the right-side chambers became slightly larger than the left-side ones. The PA was regularly larger than the Ao with an approximately constant PA/Ao ratio across gestation. Conclusions Detection rate of CHD prenatally can be improved using simple screening methods during routine ultrasound scans. Our study has developed references for twenty-one cardiac parameters in normal local Egyptian fetuses from the 20th to the 38th week of gestation to enable early detection of any abnormal deviations.