Ultrasonic Suggestive Findings of Complex Congenital Heart Diseases in Highly Selected High-Risk Fetuses During Mid-First Trimester: A Summary of Six Cases.

Objective

To explore whether ultrasound can identify findings suggestive of fetal complex congenital heart disease in highly selected high-risk fetuses during the mid-first trimester.

Methods

A retrospective analysis was conducted on 23 highly selected high-risk fetuses who related to CHD that underwent ultrasound examinations in our department between March 2015 and March 2025. Standardized scanning included mid-sagittal view, transverse views of the head, upper limbs, abdomen, lower limbs, thorax, and cardiac were obtained. A transverse scan of the cardiac was performed to obtain the color Doppler and/or gray scale four-chamber view and three-vessel-and-trachea view. Among them, six cases suspected of CHD were selected as the research objects. Ultrasound soft markers and abnormalities were recorded, and follow-up was performed with 11-14 gestational weeks recheck ultrasound, chromosomal analysis, and pathological anatomy.

Results

Ultrasound soft markers were identified in six cases. Among them, nuchal translucency thickening was observed in five cases, and severe atrioventricular valve regurgitation was detected in four cases. Extracardiac abnormalities were diagnosed in five cases, including two cases of hydrops fetalis, one case each of conjoined twins, bilateral hook-shaped hands, and hydrops fetalis complicated by gastroschisis. Three cases of functional single ventricle, one case of hypoplastic left heart, one case of complete atrioventricular septal defect, and one case of aortic arch malformation were suspected. Chromosomal abnormalities were present in four cases.

Conclusion

In highly selected high-risk fetuses, earlier fetal echocardiographic scanning may help identify findings suggestive of complex congenital heart disease during the mid-first trimester.