Changes in fetal cardiac axis between 8 and 15weeks' gestation
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 15weeks' gestation in 166 healthy pregnancies and in 10 pregnancies with seve...
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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 | 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 15weeks' 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+6weeks (Group1), 40.4±9.2° from 10+0 to 11+6weeks (Group2), 49.2±7.4° from 12+0 to 12+6weeks (Group3), 50.6±5.7° from 13+0 to 13+6weeks (Group 4) and 48.6±7.3° from 14+0 to 14+6weeks (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 |
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Methods Images from 188 fetal echocardiograms performed prospectively between 8 and 15weeks' 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+6weeks (Group1), 40.4±9.2° from 10+0 to 11+6weeks (Group2), 49.2±7.4° from 12+0 to 12+6weeks (Group3), 50.6±5.7° from 13+0 to 13+6weeks (Group 4) and 48.6±7.3° from 14+0 to 14+6weeks (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+6weeks 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 8weeks and levorotates in the late first trimester. By 12weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14+6weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [PUBLICATION ABSTRACT]</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.12478</identifier><identifier>CODEN: UOGYFJ</identifier><language>eng</language><publisher>London: Wiley Subscription Services, Inc</publisher><subject>Echocardiography</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><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></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 15weeks' gestation</title><title>Ultrasound in obstetrics & gynecology</title><description>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 15weeks' 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+6weeks (Group1), 40.4±9.2° from 10+0 to 11+6weeks (Group2), 49.2±7.4° from 12+0 to 12+6weeks (Group3), 50.6±5.7° from 13+0 to 13+6weeks (Group 4) and 48.6±7.3° from 14+0 to 14+6weeks (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+6weeks 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 8weeks and levorotates in the late first trimester. By 12weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14+6weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. 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Methods Images from 188 fetal echocardiograms performed prospectively between 8 and 15weeks' 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+6weeks (Group1), 40.4±9.2° from 10+0 to 11+6weeks (Group2), 49.2±7.4° from 12+0 to 12+6weeks (Group3), 50.6±5.7° from 13+0 to 13+6weeks (Group 4) and 48.6±7.3° from 14+0 to 14+6weeks (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+6weeks 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 8weeks and levorotates in the late first trimester. By 12weeks' gestation, the normal leftward fetal cardiac axis is established and remains stable until at least 14+6weeks. Observation of an abnormal cardiac axis in some cases of severe congenital heart disease prior to 15weeks' gestation may assist in prenatal detection. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [PUBLICATION ABSTRACT]</abstract><cop>London</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/uog.12478</doi><tpages>6</tpages></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Echocardiography |
| title | Changes in fetal cardiac axis between 8 and 15weeks' gestation |
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