January 1, 2020Romanian Journal of Morphology and EmbryologyOpen Access

Cardiac axis evaluation as a screening method for detecting cardiac abnormalities in the first trimester of pregnancy

View Full Paper

Ask AI

Bookmark

Why the study?

To investigate the association between cardiac axis and congenital heart abnormalities to evaluate its clinical utility in detecting cardiac abnormalities and aneuploidies during first-trimester ultrasound.

Does fetal cardiac axis evaluation improve the detection of major congenital cardiac abnormalities in first-trimester pregnancies compared to standard indirect markers?

Structured PICO

Does fetal cardiac axis evaluation improve the detection of major congenital cardiac abnormalities in first-trimester pregnancies compared to standard indirect markers?

Population

3,000 single-pregnancy pregnant women in the first trimester (gestational age 11 to 13+6 weeks) undergoing fetal anatomy screening.

Intervention

Fetal cardiac axis angle measurement during first-trimester ultrasound.

Comparator

Standard indirect ultrasound markers (nuchal translucency, tricuspid regurgitation, and inverted A wave on the venous duct).

Outcome

Detection of major congenital cardiac abnormalities (defined as fetal heart malformations requiring cardiac surgery or procedures during the first year of life).surrogate

Fetal cardiac axis measurement during first-trimester ultrasound is a reliable and superior indirect marker for detecting major congenital cardiac abnormalities compared to standard markers like nuchal translucency and tricuspid regurgitation.

Implication

May support first-trimester CHD screening; hypothesis-generating and requires prospective validation before clinical adoption.

Abstract

Congenital cardiac abnormalities refer to especially anatomic malformations of the heart that normally occur during fetal heart development, before eight weeks after conception. Aim: The aim is to investigate the association between cardiac axis and congenital heart abnormalities for a potential underline clinical application of cardiac axis evaluation during detection by abnormalities at the time of first trimester ultrasound. It is known that aneuploids can be associated in almost half of cases with cardiac abnormalities, so the angle of the cardiac axis could be a potential indirect marker for the detection of aneuploids in the first trimester of pregnancy. Being easy to obtain, from the cross-section at the chest level with the visualization of the four chambers, does not require additional sections to those provided in the current guides, we aim to prove its usefulness in diagnosing aneuploids and congenital cardiac abnormalities along with the translucent nuchal flow, at the level of the venous duct and the presence of tricuspid regurgitation. Conclusions: Cardiac axis has a higher value for the detection of congenital cardiac abnormalities with respect to the nuchal translucency, tricuspid regurgitation and inverted A wave at the level of the venous duct.