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Diagnostic Concept for Detecting Congenital Heart Defects in the First Trimester: Principles of Pattern Recognition

Marcin Wiechec, Agnieszka Nocun and Dominka Stettner

Objective: In this paper we describe the technique of first-trimester cardiac evaluation that is used routinely for all nuchal scans at our institution and explain the pattern recognition concept.

Early cardiac assessment is generally performed at the time of first trimester nuchal scan. At this time of gestation, the cardiac structures are already developed and their mutual geometry is fixed as it is observed in the second trimester. Information acquired during the scan should let the examiner answer the following questions: Is the fetal heart located in the normal expected position? Is the visceral situs normal? Are the two ventricles developed? Is there a normal arrangement between both arches? Are these arches balanced in size?