| |
| |
| |
| Fetal Heart Ultrasound: WHY | |
| |
| |
| Introduction | |
| |
| |
| General Notions | |
| |
| |
| Review | |
| |
| |
| Application to Fetal Cardiopathies | |
| |
| |
| References | |
| |
| |
| |
| HOW: Technical Aspects | |
| |
| |
| Physical principals of Ultrasound applied to fetal ultrasound | |
| |
| |
| Reflection of ultra sound waves | |
| |
| |
| The shortest pathway | |
| |
| |
| Getting around obstacles | |
| |
| |
| From the point of view of time | |
| |
| |
| Physical principles of Doppler | |
| |
| |
| New techniques linked to volume acquisition | |
| |
| |
| Practical controls | |
| |
| |
| Elements to Set Permanently | |
| |
| |
| The zoom | |
| |
| |
| The focus | |
| |
| |
| Gain | |
| |
| |
| Pre-set elements | |
| |
| |
| The dynamic range | |
| |
| |
| The frequency | |
| |
| |
| Beamline density | |
| |
| |
| Persistence | |
| |
| |
| Contours | |
| |
| |
| Doppler settings | |
| |
| |
| The size of the box | |
| |
| |
| The incident wave direction | |
| |
| |
| PRF | |
| |
| |
| Color gain | |
| |
| |
| The use of Ultrasound in examining the fetal heart | |
| |
| |
| Echo-structure | |
| |
| |
| The fetal heart position | |
| |
| |
| Movements of the target | |
| |
| |
| Technical Pitfalls | |
| |
| |
| Problems linked to exposure in the zone of interest | |
| |
| |
| Ultrasound windows | |
| |
| |
| Setting Pitfalls | |
| |
| |
| Further Reading | |
| |
| |
| |
| HOW: Anatomic ultrasound correlations: 3 steps, 10 key points | |
| |
| |
| 1st step: Position: 2 key points | |
| |
| |
| Lateralization | |
| |
| |
| Organs | |
| |
| |
| Vessels | |
| |
| |
| The axis of the heart | |
| |
| |
| 2nd Step, Inflow: 4 key points | |
| |
| |
| Heart, Diaphragm and pulmonary veins | |
| |
| |
| 4 Chambers | |
| |
| |
| Contractile, balanced, Concordant | |
| |
| |
| Crux-of-the-Heart, rings and offsetting | |
| |
| |
| 3rd step, Outflow: 4 key points | |
| |
| |
| 2 balanced Outlet chambers with the alignment of the septum | |
| |
| |
| 2 superimposed and crossed arched vessels | |
| |
| |
| Balanced and Concordant | |
| |
| |
| Regular Aortic Arch | |
| |
| |
| References | |
| |
| |
| |
| HOW: Conducting the examination and its pitfalls | |
| |
| |
| |
| |
| |
| A Fast glance | |
| |
| |
| Views verifying the 10 key points and their pitfalls | |
| |
| |
| The lift, verification of the position and its pitfalls | |
| |
| |
| The technique | |
| |
| |
| Its pitfalls: elements of lateralization | |
| |
| |
| Organ position | |
| |
| |
| Vessel position | |
| |
| |
| The four chamber view: inlet verification and its pitfalls | |
| |
| |
| The technique | |
| |
| |
| Axial apical pathway | |
| |
| |
| Crux-of-the-heart | |
| |
| |
| Pitfalls | |
| |
| |
| The Ao and apex of the heart on the same side to the Left | |
| |
| |
| The heart's axis | |
| |
| |
| The Swings | |
| |
| |
| Lateral fluctuation: asymmetries | |
| |
| |
| Anterior-posterior movements: false AVSD and false VSD | |
| |
| |
| View LV-Aorta | |
| |
| |
| Axial-apical view | |
| |
| |
| Axial lateral view | |
| |
| |
| "SOS" view: Sagittal and its pitfalls | |
| |
| |
| View RV-PT | |
| |
| |
| Axial view | |
| |
| |
| Small axis view and its pitfalls | |
| |
| |
| The 3 vessel or 2 arches view | |
| |
| |
| Pitfalls | |
| |
| |
| Sagittal view and the aortic arch | |
| |
| |
| Pitfalls | |
| |
| |
| Further Reading | |
| |
| |
| References | |
| |
| |
| |
| WHY: Critical cardiac pathologies not to be overlooked | |
| |
| |
| 1st Step: Position pathologies: 2 key points | |
| |
| |
| Position anomalies of the organs, of situs | |
| |
| |
| Vessel Position | |
| |
| |
| Anomalies of the Position of the Heart | |
| |
| |
| In the right thorax | |
| |
| |
| Heart axis. 2nd Step: Inlet Pathologies: 4 key points | |
| |
| |
| Anomalies of pulmonary venous return | |
| |
| |
| Irregular number of chambers: 3, 4+ or 5 chambers | |
| |
| |
| Unbalanced | |
| |
| |
| Abnormalities of the atrioventricular valves: atresia of one AV valve and the Spectrum of AVSD | |
| |
| |
| 3rd Step: Outflow pathologies: 4 key points | |
| |
| |
| VSD misalignment in CTC | |
| |
| |
| Complete transposition of the great vessels | |
| |
| |
| Hypoplasia of the Left tract, ventricular-arterial discordances and position errors | |
| |
| |
| Aortic Coarctation of the Ao, Interruption of the Aortic arch | |
| |
| |
| References | |
| |
| |
| |
| WHEN: Fetal morphological examination after the discovery of a cardiopathy | |
| |
| |
| Unknown Karyotypes | |
| |
| |
| Investigation for signs associated with the principal chromosomal anomalies | |
| |
| |
| Normal known karyotype | |
| |
| |
| Investigation of a micro-deletion 22 q11 or signs linked with Associations, or genetic syndromes | |
| |
| |
| Cardiopathy and Intra uterine retarded growth (IURG) | |
| |
| |
| Fetal alcohol syndrome. VACTERL syndrome | |
| |
| |
| References | |
| |
| |
| |
| Points to remember | |
| |
| |
| Technical points | |
| |
| |
| Key points in the heart exam | |
| |
| |
| Morphology | |
| |
| |
| Further Reading | |