Echocardiographic detection of congenital heart disease in the fetus: present and future

摘要

During the 1970s, ultrasound rapidly developed into a reliable tool for the prenatal diagnosis of malformations in many organ systems. However, the cardiovascular system was avoided, partly because real-time imaging was not yet available and partly because of the apparent anatomical complexity of the heart and the variety of structural abnormalities. It was not until the advent of cross sectional imaging in the late 1970s and early 1980s, that cardiac imaging became practical. At this time paediatric cardiologists were beginning to learn the value of the echocardiogram for the diagnosis of congenital heart disease in postnatal life. Simultaneously, they became aware of the improved quality of prenatal imaging and several workers in different centres made a systematic study of the fetal heart. Over the next few years, it became established that normal fetal cardiac anatomy could be reliably identified and that the diagnosis of structural abnormality was also possible. Since then, improved resolution of ultrasound equipment and the addition of pulsed, continuous wave and colour flow Doppler have all added to the information that can be obtained prenatally.