Changes in fetal cardiac axis between 8 and 15 weeks' gestation
ABSTRACT Objectives To document changes in the normal embryonic/fetal cardiac axis in the late first and early second trimesters of pregnancy. Methods Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks' gestation in 166 healthy pregnancies and in 10 pregnancies...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2013-12, Vol.42 (6), p.653-658 |
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| container_title | Ultrasound in obstetrics & gynecology |
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| creator | McBrien, A. Howley, L. Yamamoto, Y. Hutchinson, D. Hirose, A. Sekar, P. Jain, V. Motan, T. Trines, J. Savard, W. Hornberger, L. K. |
| description | ABSTRACT
Objectives
To document changes in the normal embryonic/fetal cardiac axis in the late first and early second trimesters of pregnancy.
Methods
Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks' gestation in 166 healthy pregnancies and in 10 pregnancies with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four‐chamber view. Differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies were compared.
Results
The mean ± SD embryonic/fetal cardiac axis was 25.5 ± 11.5° from 8 + 0 to 9 + 6 weeks (Group 1), 40.4 ± 9.2° from 10 + 0 to 11 + 6 weeks (Group 2), 49.2 ± 7.4° from 12 + 0 to 12 + 6 weeks (Group 3), 50.6 ± 5.7° from 13 + 0 to 13 + 6 weeks (Group 4) and 48.6 ± 7.3° from 14 + 0 to 14 + 6 weeks (Group 5). Groups 1 and 2 were significantly different from each other and all other groups (P |
| doi_str_mv | 10.1002/uog.12478 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1461866784</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1461866784</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3608-6f14c0da9c3ccc15039a463cf1ed8cc82a0c93fa37507e2e32944715cd0058923</originalsourceid><addsrcrecordid>eNp1kLtOwzAUQC0EoqUw8APIGzCkvX7Ej7GqoCBVYqGz5TpOCaRJiVOVbqz8Jl-CIYWNybrSuefKB6FzAkMCQEebejkklEt1gPqEC52AhPQQ9UELSKTQtIdOQngGAMGZOEY9yqlkFEgfjSdPtlr6gIsK5761JXa2yQrrsH0rAl74dut9hRW2VYZJ-vn-EeeXcInjTmvboq5O0VFuy-DP9u8AzW9vHid3yexhej8ZzxLHBKhE5IQ7yKx2zDlHUmDacsFcTnymnFPUgtMst0ymID31jGrOJUldBpAqTdkAXXXedVO_buJ1syqC82VpK19vgokfJ0oIqXhErzvUNXUIjc_NuilWttkZAua7mInFzE-xyF7stZvFymd_5G-iCIw6YFuUfve_ycwfpp3yC2F6c7o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1461866784</pqid></control><display><type>article</type><title>Changes in fetal cardiac axis between 8 and 15 weeks' gestation</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Online Library (Open Access Collection)</source><creator>McBrien, A. ; Howley, L. ; Yamamoto, Y. ; Hutchinson, D. ; Hirose, A. ; Sekar, P. ; Jain, V. ; Motan, T. ; Trines, J. ; Savard, W. ; Hornberger, L. K.</creator><creatorcontrib>McBrien, A. ; Howley, L. ; Yamamoto, Y. ; Hutchinson, D. ; Hirose, A. ; Sekar, P. ; Jain, V. ; Motan, T. ; Trines, J. ; Savard, W. ; Hornberger, L. K.</creatorcontrib><description>ABSTRACT
Objectives
To document changes in the normal embryonic/fetal cardiac axis in the late first and early second trimesters of pregnancy.
Methods
Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks' gestation in 166 healthy pregnancies and in 10 pregnancies with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four‐chamber view. Differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies were compared.
Results
The mean ± SD embryonic/fetal cardiac axis was 25.5 ± 11.5° from 8 + 0 to 9 + 6 weeks (Group 1), 40.4 ± 9.2° from 10 + 0 to 11 + 6 weeks (Group 2), 49.2 ± 7.4° from 12 + 0 to 12 + 6 weeks (Group 3), 50.6 ± 5.7° from 13 + 0 to 13 + 6 weeks (Group 4) and 48.6 ± 7.3° from 14 + 0 to 14 + 6 weeks (Group 5). Groups 1 and 2 were significantly different from each other and all other groups (P < 0.05). The results for 22 cases with repeat measurements from 8 + 0 to 11 + 6 and 12 + 0 to 14 + 6 weeks confirmed that the embryonic/fetal cardiac axis increased significantly (P < 0.001). In the cases with severe congenital heart disease, the cardiac axis was > 90th centile in four cases and < 10th centile in two cases.
Conclusions
The embryonic cardiac axis is relatively midline at 8 weeks and levorotates in the late first trimester. By 12 weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14 + 6 weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15 weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.12478</identifier><identifier>PMID: 24273201</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>axis ; cardiac development ; Echocardiography ; Female ; Fetal Development ; Fetal Diseases - diagnostic imaging ; fetal echocardiography ; fetal heart ; Fetal Heart - abnormalities ; Fetal Heart - diagnostic imaging ; first trimester ; Gestational Age ; Heart - embryology ; Heart Defects, Congenital - diagnostic imaging ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; reference values ; Ultrasonography, Prenatal ; Ventricular Septum - diagnostic imaging ; Ventricular Septum - embryology</subject><ispartof>Ultrasound in obstetrics & gynecology, 2013-12, Vol.42 (6), p.653-658</ispartof><rights>Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3608-6f14c0da9c3ccc15039a463cf1ed8cc82a0c93fa37507e2e32944715cd0058923</citedby><cites>FETCH-LOGICAL-c3608-6f14c0da9c3ccc15039a463cf1ed8cc82a0c93fa37507e2e32944715cd0058923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.12478$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.12478$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24273201$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McBrien, A.</creatorcontrib><creatorcontrib>Howley, L.</creatorcontrib><creatorcontrib>Yamamoto, Y.</creatorcontrib><creatorcontrib>Hutchinson, D.</creatorcontrib><creatorcontrib>Hirose, A.</creatorcontrib><creatorcontrib>Sekar, P.</creatorcontrib><creatorcontrib>Jain, V.</creatorcontrib><creatorcontrib>Motan, T.</creatorcontrib><creatorcontrib>Trines, J.</creatorcontrib><creatorcontrib>Savard, W.</creatorcontrib><creatorcontrib>Hornberger, L. K.</creatorcontrib><title>Changes in fetal cardiac axis between 8 and 15 weeks' gestation</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>ABSTRACT
Objectives
To document changes in the normal embryonic/fetal cardiac axis in the late first and early second trimesters of pregnancy.
Methods
Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks' gestation in 166 healthy pregnancies and in 10 pregnancies with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four‐chamber view. Differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies were compared.
Results
The mean ± SD embryonic/fetal cardiac axis was 25.5 ± 11.5° from 8 + 0 to 9 + 6 weeks (Group 1), 40.4 ± 9.2° from 10 + 0 to 11 + 6 weeks (Group 2), 49.2 ± 7.4° from 12 + 0 to 12 + 6 weeks (Group 3), 50.6 ± 5.7° from 13 + 0 to 13 + 6 weeks (Group 4) and 48.6 ± 7.3° from 14 + 0 to 14 + 6 weeks (Group 5). Groups 1 and 2 were significantly different from each other and all other groups (P < 0.05). The results for 22 cases with repeat measurements from 8 + 0 to 11 + 6 and 12 + 0 to 14 + 6 weeks confirmed that the embryonic/fetal cardiac axis increased significantly (P < 0.001). In the cases with severe congenital heart disease, the cardiac axis was > 90th centile in four cases and < 10th centile in two cases.
Conclusions
The embryonic cardiac axis is relatively midline at 8 weeks and levorotates in the late first trimester. By 12 weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14 + 6 weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15 weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.</description><subject>axis</subject><subject>cardiac development</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Fetal Development</subject><subject>Fetal Diseases - diagnostic imaging</subject><subject>fetal echocardiography</subject><subject>fetal heart</subject><subject>Fetal Heart - abnormalities</subject><subject>Fetal Heart - diagnostic imaging</subject><subject>first trimester</subject><subject>Gestational Age</subject><subject>Heart - embryology</subject><subject>Heart Defects, Congenital - diagnostic imaging</subject><subject>Humans</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, First</subject><subject>Pregnancy Trimester, Second</subject><subject>reference values</subject><subject>Ultrasonography, Prenatal</subject><subject>Ventricular Septum - diagnostic imaging</subject><subject>Ventricular Septum - embryology</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtOwzAUQC0EoqUw8APIGzCkvX7Ej7GqoCBVYqGz5TpOCaRJiVOVbqz8Jl-CIYWNybrSuefKB6FzAkMCQEebejkklEt1gPqEC52AhPQQ9UELSKTQtIdOQngGAMGZOEY9yqlkFEgfjSdPtlr6gIsK5761JXa2yQrrsH0rAl74dut9hRW2VYZJ-vn-EeeXcInjTmvboq5O0VFuy-DP9u8AzW9vHid3yexhej8ZzxLHBKhE5IQ7yKx2zDlHUmDacsFcTnymnFPUgtMst0ymID31jGrOJUldBpAqTdkAXXXedVO_buJ1syqC82VpK19vgokfJ0oIqXhErzvUNXUIjc_NuilWttkZAua7mInFzE-xyF7stZvFymd_5G-iCIw6YFuUfve_ycwfpp3yC2F6c7o</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>McBrien, A.</creator><creator>Howley, L.</creator><creator>Yamamoto, Y.</creator><creator>Hutchinson, D.</creator><creator>Hirose, A.</creator><creator>Sekar, P.</creator><creator>Jain, V.</creator><creator>Motan, T.</creator><creator>Trines, J.</creator><creator>Savard, W.</creator><creator>Hornberger, L. K.</creator><general>John Wiley & Sons, Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201312</creationdate><title>Changes in fetal cardiac axis between 8 and 15 weeks' gestation</title><author>McBrien, A. ; Howley, L. ; Yamamoto, Y. ; Hutchinson, D. ; Hirose, A. ; Sekar, P. ; Jain, V. ; Motan, T. ; Trines, J. ; Savard, W. ; Hornberger, L. K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3608-6f14c0da9c3ccc15039a463cf1ed8cc82a0c93fa37507e2e32944715cd0058923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>axis</topic><topic>cardiac development</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Fetal Development</topic><topic>Fetal Diseases - diagnostic imaging</topic><topic>fetal echocardiography</topic><topic>fetal heart</topic><topic>Fetal Heart - abnormalities</topic><topic>Fetal Heart - diagnostic imaging</topic><topic>first trimester</topic><topic>Gestational Age</topic><topic>Heart - embryology</topic><topic>Heart Defects, Congenital - diagnostic imaging</topic><topic>Humans</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, First</topic><topic>Pregnancy Trimester, Second</topic><topic>reference values</topic><topic>Ultrasonography, Prenatal</topic><topic>Ventricular Septum - diagnostic imaging</topic><topic>Ventricular Septum - embryology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McBrien, A.</creatorcontrib><creatorcontrib>Howley, L.</creatorcontrib><creatorcontrib>Yamamoto, Y.</creatorcontrib><creatorcontrib>Hutchinson, D.</creatorcontrib><creatorcontrib>Hirose, A.</creatorcontrib><creatorcontrib>Sekar, P.</creatorcontrib><creatorcontrib>Jain, V.</creatorcontrib><creatorcontrib>Motan, T.</creatorcontrib><creatorcontrib>Trines, J.</creatorcontrib><creatorcontrib>Savard, W.</creatorcontrib><creatorcontrib>Hornberger, L. K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McBrien, A.</au><au>Howley, L.</au><au>Yamamoto, Y.</au><au>Hutchinson, D.</au><au>Hirose, A.</au><au>Sekar, P.</au><au>Jain, V.</au><au>Motan, T.</au><au>Trines, J.</au><au>Savard, W.</au><au>Hornberger, L. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in fetal cardiac axis between 8 and 15 weeks' gestation</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2013-12</date><risdate>2013</risdate><volume>42</volume><issue>6</issue><spage>653</spage><epage>658</epage><pages>653-658</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><abstract>ABSTRACT
Objectives
To document changes in the normal embryonic/fetal cardiac axis in the late first and early second trimesters of pregnancy.
Methods
Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks' gestation in 166 healthy pregnancies and in 10 pregnancies with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four‐chamber view. Differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies were compared.
Results
The mean ± SD embryonic/fetal cardiac axis was 25.5 ± 11.5° from 8 + 0 to 9 + 6 weeks (Group 1), 40.4 ± 9.2° from 10 + 0 to 11 + 6 weeks (Group 2), 49.2 ± 7.4° from 12 + 0 to 12 + 6 weeks (Group 3), 50.6 ± 5.7° from 13 + 0 to 13 + 6 weeks (Group 4) and 48.6 ± 7.3° from 14 + 0 to 14 + 6 weeks (Group 5). Groups 1 and 2 were significantly different from each other and all other groups (P < 0.05). The results for 22 cases with repeat measurements from 8 + 0 to 11 + 6 and 12 + 0 to 14 + 6 weeks confirmed that the embryonic/fetal cardiac axis increased significantly (P < 0.001). In the cases with severe congenital heart disease, the cardiac axis was > 90th centile in four cases and < 10th centile in two cases.
Conclusions
The embryonic cardiac axis is relatively midline at 8 weeks and levorotates in the late first trimester. By 12 weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14 + 6 weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15 weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>24273201</pmid><doi>10.1002/uog.12478</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Ultrasound in obstetrics & gynecology, 2013-12, Vol.42 (6), p.653-658 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library (Open Access Collection) |
| subjects | axis cardiac development Echocardiography Female Fetal Development Fetal Diseases - diagnostic imaging fetal echocardiography fetal heart Fetal Heart - abnormalities Fetal Heart - diagnostic imaging first trimester Gestational Age Heart - embryology Heart Defects, Congenital - diagnostic imaging Humans Pregnancy Pregnancy Trimester, First Pregnancy Trimester, Second reference values Ultrasonography, Prenatal Ventricular Septum - diagnostic imaging Ventricular Septum - embryology |
| title | Changes in fetal cardiac axis between 8 and 15 weeks' gestation |
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