JCK Oral 2 (II-JCKO2)
Fetal and Neonatal Cardiology

[II-JCKO2-04] Basic Fetal Echocardiography

^○Sin-weon Yun (Department of Pediatric Cardiology, Chung-Ang University Hospital, Korea )

In recent years, marked advances in the technology, the field of prenatal diagnosis of congenital heart disease(CHD) is no longer unfamiliar. Understanding of antenatal diagnosis of the significant heart anomalies can be marked to improve neonatal outcome. Nevertheless, CHDs are the most frequently overlooked fields during fetal work-up, and thus may lead medicolegal, socioeconomic and psychological problems. Antenatal detection of cardiac anomalies is commonly made between 18th ~ 24th weeks of gestational age. Subtle clues in the early life may important key of diagnosis. Fetal sonographers and pediatric cardiologist need familiar with normal and abnormal fetal sequential axial scan. There are standard several transverse and sagittal views, Transverse views are easy to obtain and be standardized. Furthermore, a serial transverse section provides anatomic information. The other views parallel to the fetal long axis can be divided into coronal and longitudinal views. Coronal views are hardly possible to get or informative. It can always emphasize that serial axial scanning is important. Confirmed with 2D and check the flow pattern with color and Doppler, and try to find any great arteries discrepancies and isthmus hypoplasia. And confirm the normal pulmonary venous return use low velocity color Doppler. Some CHDs such as so-called right side obstructive lesions (such as pulmonary stenosis, tetralogy of the Fallot, pulmonary atresia series) and left sided obstructive lesions (such as critical aortic stenosis, hypoplastic left heart syndrome, coarctation of the aorta, interrupted aortic arch series) may progress into the gestational age, so if suspicious these anomalies, regular follow- up for progression is mandatory. And examiner’s experience and acknowledge of the postnatal outcome may greatly influence to the counseling attitude and final fetal outcome. Some serious cardiac lesions may need emergency intervention just after delivery, so decide for delivery plan also crucial for outcome.