Learning Curve and Factors Influencing the Feasibility of Performing Fetal Echocardiography at the Time of the First‐Trimester Scan

• Published in: Journal of ultrasound in medicine Vol. 30; no. 5; pp. 695 - 700
• Main Authors: Abu-Rustum, Reem S., Ziade, M. Fouad, Abu-Rustum, Sameer E.
• Format: Journal Article
• Language: English
• Published: England American Institute of Ultrasound in Medicine 01.05.2011
• Subjects: Echocardiography - methods; Echocardiography - statistics & numerical data; Feasibility Studies; Female; fetal echocardiography; first trimester; Humans; Learning Curve; Lebanon; Male; Pregnancy; Pregnancy Trimester, First; Professional Competence - statistics & numerical data; Reproducibility of Results; Sensitivity and Specificity; Ultrasonography, Prenatal - methods; Ultrasonography, Prenatal - statistics & numerical data; Lebanon
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/jum.2011.30.5.695

The purpose of this study was to assess the learning curve and factors influencing the feasibility of performing a complete fetal cardiac examination at the time of the first‐trimester scan. The study included 103 fetuses undergoing first‐trimester scans. The maternal body mass index, fetal crown‐rump length, and 8 cardiac parameters were evaluated: 4‐chamber view, tricuspid regurgitation, outflow tract crossover, bifurcating pulmonary artery, 3‐vessel view, aortic arch, superior and inferior venae cavae on sagittal views, and Doppler images of the ductus venosus. All examinations were performed transabdominally by a single sonologist. The average times from the first to last cardiac images obtained were calculated. A complete examination was feasible in 55% of the cases: 15% of the first 52 and 94% of the last 51. Of the 8 cardiac parameters, 59.5% were seen in cases 1 to 21, 75.0% in cases 22 to 52, and 98.6% in the last 51 cases (P = .0001). The average times spent on the examinations increased from 4.37 to 9.3 minutes among the 3 groups (P = .032). There was no statistically significant influence for the crown‐rump length (P = .899) or body mass index (P = .752). This study indicates that a fetal cardiac examination is feasible in the first trimester. Sonographer experience and the examination duration seem to be the most influential factors affecting the completeness of the examination.