Fetal echocardiographic assessment: impact of gestational age and maternal obesity.

Introduction: To identify the ability to acquire various fetal cardiac views using two-dimensional ultrasound at different gestational age and body mass index (BMI) categories. Material and methods: We performed a prospective observational study among low-risk women with singleton pregnancies attending the University Obstetrics Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka. The ability to obtain satisfactory views for the situs, four chambers (4CH), right and left outflow tracts (ROFT/LOFT), three vessels (3V), aortic arch (AA), ductal arch (DA), and superior and inferior vena cava (SVC/IVC) of fetal heart was studied. Results: A total of 314 eligible pregnant women underwent fetal echocardiography and 288 had complete data. All eight cardiac views were obtained with a 100% success at the gestational age of 18 to 21+6 weeks. All eight cardiac views were satisfactory in more than 97% at the gestational age of 22 to 25+ 6 weeks. BMI was not significantly associated with acquisition of cardiac views at all gestations (Log-rank test, p=0.62). All eight cardiac views were obtained with 50% success at 14 -17+6 weeks and 5.4% success at 11-13+6 weeks. Conclusions: The ability to acquire all fetal cardiac views was best at 18 to 21+6 weeks of gestation, but reasonably successful till 26 weeks. The acquisition of all cardiac views was sub-optimal in early gestations below 18 weeks and for some of the cardiac views after 26 weeks. BMI does not hamper the ability to obtain cardiac views during fetal echocardiography.