Abstract
The chances of detecting congenital heart disease are improved following
structured protocols. Fetal heart disease is one of the main serious
congenital malformations. The objective of this review is to present the
benefits of sequential and routine cardiac evaluation in the first and
early second trimesters and to identify the structures and pathologies
that can be detected at this gestational age. The databases of PubMed,
Medline, MD consult, Embase, Clinical Key, Scielo, and ScienceDirect, as
well as specialized texts in Spanish and English were searched for
diagnostic studies, systematic reviews, and meta-analysis related to the
terms “early fetal echocardiography” and “congenital heart
malformations” published between 2000 and 2019. Technological advances
have revolutionized the fetal echocardiographic examination making
possible the diagnosis of congenital heart disease from the first and
early second trimester of pregnancy. However, it should be recognized
that early fetal echocardiography has limitations such as the evaluation
of pulmonary veins and cardiac lesions that are progressive. The benefit
found was earlier detection of pathologies with high sensitivity and
specificity. A fetal cardiac evaluation sequence was included in these
early fetal echocardiographic examinations due to the awareness of fetal
anatomical and hemodynamic differences in the first trimester and the
beginning of the second trimester. Early fetal echocardiography is a
very useful tool for the detection of congenital heart disease; it
allows parents to be informed about the prognosis and possible
treatments early. Fetal cardiac examination in the first trimester is
safe and can detect the most of heart congenital malformation.