As early as 14 weeks gestation, doctors can now visualize and do a more complete assessment of the heart in utero

Imagine this: Joseph Smith is just a few minutes old, and his family can’t wait to meet him – but first he has an appointment with a heart surgeon. During his mother’s pregnancy, doctors using a new medical imaging technology found a defect in Joseph’s heart that if not repaired could cause a serious condition, or even death, during infancy.

An immediate and successful surgery will mean Joseph will have the opportunity to live a long and healthy life. The technology that is helping doctors find fetal heart defects is the 4D ultrasound system. It lets doctors look at multi-dimensional images of a fetus’ heart. By identifying heart defects in the early stages of a woman’s pregnancy, doctors can recommend proper care to give the baby the best possible chance of survival.

Joseph isn’t a real child, but his story is all too common: as many as one in every 250 babies are born with heart defects.

“Congenital heart defects are the most common of all birth defects, and they are a major cause of infant death,” DeVore said. “This is because newborns’ heart defects are often not identified before birth. Mother and child are sent home with no suspicion of a problem, and only when the baby becomes ill does the problem come to light. Emergency surgery is then often required to save the child’s life.”

The 4D ultrasound system can change that scenario. The system uses an advanced technique called Spatial Temporal Image Correlation (STIC) to gather a volume of data that allows clinicians to create detailed three-dimensional images of the heart that can be viewed in the fourth-dimension: real-time motion. These images allow doctors to visualize an entire fetal heart cycle from start to finish, including the workings of the heart chambers, the fluttering of the heart valves, and the flow of blood in the heart and its vessels.

4D ultrasound with STIC is improving our ability to discover heart defects in utero, This technology allows clinicians who do not specialize in heart care to see more detail and more easily evaluate the anatomy, which may improve our overall detection rate of heart defects before birth.

For many years, ultrasound, which creates clinical images using high-frequency sound waves, has been a safe and effective way to assess the health of a fetus. However, a fetal heart has been one of the most difficult organs to image because of its size and constant motion. At the 14th week of pregnancy, for example, the fetal heart is about the size of half a pea, and it beats approximately 160 times per minute, more than twice as fast as an adult’s heart. In addition, a fetus moves unpredictably – scanning the heart is like aiming at a moving target.

The 4D ultrasound system enables clinicians to make a real-time assessment of the fetal heart during the exam, and/or save the data for future assessment. With  STIC technology, clinicians can use the ultrasound images to navigate through the heart, view images from different angles and run the images at actual speed, or in slow-motion, to evaluate the vessels and blood flow.

Usually, 4D fetal heart ultrasound exams are performed on high-risk patients or if a traditional prenatal ultrasound study, or some other information, indicates a possible heart condition. If the 4D ultrasound STIC exam indicates a condition, doctors can advise the mother on changes in prenatal behavior that may reduce risk to the fetus, and create a treatment plan to correct the problem after birth.

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