Real‐time three‐dimensional fetal echocardiography: initial feasibility study.

Real‐time three‐dimensional echocardiography acquires data as a volume rather than as a series of planar images, thereby obviating cardiac or respiratory gating and limiting artifacts generated by random motion. This study was undertaken to evaluate the feasibility of using real‐time three‐dimensional echocardiography to evaluate fetal cardiac anatomy and function. Ten human fetuses were evaluated in utero, four of whom had congenital heart disease. Freehand transabdominal scanning was performed on each pregnant woman using a real‐time three‐dimensional echocardiography system. Four volume clips at 20 volumes/s of duration 1.5 s each were obtained on each fetal heart and stored for off‐line analysis. Data were displayed immediately as a series of four simultaneous planes, with the ability for the observer to manipulate the position of each plane within the acquired volume data set. Cardiac motion could be slowed, stopped, or viewed at its original speed. Most structures and views, as well as cardiac function, could be visualized consistently. Abnormal structures could be detected readily. Off‐line analysis was rapid and easy. We conclude that fetal real‐time three‐dimensional echocardiography is a feasible, facile, and rapid new technique.