Evaluation of the right and left ventricles: An integrated approach measuring the area, length, and width of the chambers in normal fetuses.

INTRODUCTION: The purpose of this study was to simultaneously measure with speckle tracking software the end-diastolic ventricular area (A), basal transverse width (BW), mid-chamber transverse width (MW), and basal-apical length (BAL) in normal fetuses and those with pathology.

METHODS: The 4-chamber view of the fetal heart was obtained in 200 control fetuses between 20 and 40 weeks of gestation and in 9 third-trimester fetuses with heart malformations. The mean and standard deviation for the A, BW, MW, and BAL were computed from the control fetuses and Z scores computed from the 9 fetuses with cardiac malformations.

RESULTS: The A, BAL, BW, and MW were correlated with 7 somatic and age-independent variables (R2  = .63-.85). The highest R2 values occurred for the head circumference, estimated fetal weight, and ultrasound mean gestational age (.82-.85). Z-score values and centiles from the 9 fetuses with cardiac malformations suggested that the A, BW, MW, and BAL were below or above the 5th and 95th centiles as expected for the corresponding ventricular pathology.

CONCLUSIONS: This study reports an integrated approach to evaluate the end-diastolic size of the right and left ventricular chambers and demonstrated clinical utility in fetuses with cardiac malformations.