The role of ultrasound in the assessment of fetal heart function

Ultrasound is an imaging method to help assess fetal status such as: heart rate, fetal heart function, etc., so that abnormal abnormalities of the fetus can be detected early and measures can be taken. appropriate treatment in early pregnancy.

The human heart is a complex structure with features including: 4 chambers, 4 main heart valves and many other arteries and veins. However, the fetal heart structure is almost complete with the division of heart chambers and heart valves and blood vessels by the 8th week of pregnancy. Features of fetal heart include:
Parallel circulation; There is a mixing of blood in the veins returning to the heart; Both intracardiac and extracardiac shunts exist; Resistance of pulmonary circulation is high; Resistance of the placental circulation is low; The heart and brain have the most oxygenated blood from the umbilical vein; The lower part of the body receives the least oxygenated blood; Oxygen concentration in the inferior vena cava is higher than in the superior vena cava; The partial pressure pO2 is highest in the umbilical vein. The difference between circulation and fetal heart function:
Fetal myocardial fibers have a lower ability to stretch than adults; The percentage of non-contractile protein fibers in fetal cells is higher than after birth; The more mature the heart muscle, the better its ability to stretch; Diastolic performance is less affected by contractile factors; Heart rate fluctuations ensure that cardiac output is limited; The right ventricle pumps total cardiac output into the dominant descending aorta; A higher volume of oxygenated blood is supplied by the left ventricle but a lower ejection fraction contributing to total CO; When filling the ventricles in the uterine cavity, the ability to dilate is poor.

Some disorders of fetal cardiac dysfunction include:
Fetal cardiomyopathy: cardiomyopathy, myocarditis, fibrosis, calcification,... Heart disease causing increased cardiac output: Open disease Congenital heart valve, congenital heart disease with biventricular outflow tract obstruction, atrioventricular - ventricular valve abnormalities, twins sharing heart, twin-twin transfusion syndrome, hemangioma, ductal aplasia,... Problems with arrhythmias such as: atrioventricular block, supraventricular tachycardia,... Anemia: Alpha thalassemia, parvovirus B19 infection,... Increased myocardial pressure including: Pericardial effusion , pleura, and abnormal masses in the chest,...

Fetal echocardiography is one of the diagnostic methods, in the antenatal period recommended by doctors to diagnose, detect and have appropriate treatment early. The role of ultrasound in assessing fetal heart function includes:
Monitoring the fetal cardiovascular development; Identify risk factors, detect signs of cardiovascular abnormalities; Prognosis and prevention, prediction of cardiovascular consequences after birth; Combination in treatment: clinical monitoring. Techniques to evaluate fetal heart function on ultrasound include:
Evaluation of fetal heart systolic function; Assess fetal cardiac diastolic function; Assess fetal cardiac function; Evaluation of biological scale; Evaluation of cyclic redistribution. The steps to evaluate fetal heart function are as follows:
Assess the size and function of the fetal heart: The area index of the fetal heart / thoracic cavity, the fraction of muscle fiber shortening, and the degree of heart valve regurgitation, .. Assess for abnormalities of venous flow such as: increased end-diastolic pressure, increased reverse flow in the inferior vena cava, ductus venosus, umbilical vein, oscillation. Assessment of arterial flow abnormalities: Circulatory redistribution Evaluation of effusion Evaluation of the whole fetal heart.

In addition to regular fetal ultrasound, pregnant women need to note important milestones to conduct fetal echocardiography such as:
From the 8th to the 10th week of pregnancy: The fetal heart has begun to appear, so During this period, the fetal heart rate can be assessed. From the 20th week of pregnancy: The fetal heart is about the size of a dime and begins to evaluate for position, size, and morphology on 4D ultrasound. From there, it is possible to assess the function of the fetal heart. Most mothers have fetal echocardiography during routine antenatal check-ups. However, the doctor recommends that the following subjects need to perform fetal echocardiography from the time the fetal heart is formed, including:
Relatives in the pregnant woman's family have a history of heart disease; Pregnant women with autoimmune diseases during pregnancy; Using drugs that affect the fetus such as: anticonvulsants, antidepressants,... The fetus is artificially inseminated; Pregnant women have other unusual signs. In summary, ultrasound in assessing fetal heart function is a method of antenatal imaging, helping to monitor heart development, early detection of abnormalities, and early intervention measures in the early stages. of pregnancy. The second trimester of pregnancy is a period of strong fetal development. Pregnant women need:
Comprehensive fetal malformation screening by superior 4D ultrasound technique. Screening for gestational diabetes, avoiding many dangerous complications for both mother and baby. Control the mother's weight reasonably to assess the health status of the pregnant woman and the development of the fetus. Understand the signs of threatened early delivery (especially in those carrying multiple pregnancies or having a history of miscarriage or premature birth) so that they can receive timely treatment to maintain pregnancy. To protect mother and baby during pregnancy, Vinmec provides a comprehensive Maternity service to monitor the health status of mother and baby, periodical antenatal check-ups with leading Obstetricians and Gynecologists. enough tests, important screening for pregnant women, counseling and timely intervention when detecting abnormalities in the health of mother and baby.
For detailed information about all-inclusive maternity packages, please contact the hospitals and clinics of the Vinmec health system nationwide.