Changes in the Cardiac Axis from 8 to 14+6 Weeks of Gestation A McBrien*, L Howley*, Y Yamamoto*, Darren Hutchinson*, A Hirose*, P Sekar*, V Jain†, T Motan†, J Trines*, W Savard* and LK Hornberger*†
*
Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology,
University of Alberta, Edmonton, Alberta, Canada †
Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta,
Canada; Women’s & Children’s Health Research Institute, Mazankowski Alberta Heart Institute Current affiliations: L Howley, Pediatric Cardiology, Children’s Hospital Colorado, University of Colorado, Aurora, Colorado, USA; Y Yamamoto, Obstetrics & Gynecology, Juntendo University School of Medicine, Tokyo, Japan; P Sekar, Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Corresponding author: Dr L.K. Hornberger, Pediatric Cardiology, Stollery Children's Hospital, WMC 4C1.19 8440 - 112 Street, Edmonton, Alberta, Canada, T6G 2B7 Email: [email protected]; Telephone: 001 780 4073355, Fax: 001 780 4073954 Keywords: fetal heart, axis, first trimester, fetal echocardiography, reference values, cardiac development
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/uog.12478 Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
This article is protected by copyright. All rights reserved
Abstract
Objectives: This study aimed to document the changes in the normal embryonic/fetal cardiac axis in the late first and early second trimester of pregnancy. Methods: Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks gestation in 166 healthy pregnancies and in 10 with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four chamber view. One-way analysis of variance followed by Tukey’s multiple comparison test were used to compare differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies. For paired results, the embryonic/fetal cardiac axis change was compared using Wilcoxon signed-rank testing Results: The mean embryonic/fetal cardiac axis was 25.5 ±11.5O from 8-9+6 weeks (Group 1), 40.4 ±9.2O from 10-11+6 weeks (Group 2), 49.2 ±7.4O from 12-12+6 weeks (Group 3), 50.6 ± 5.7O from 13-13+6 weeks (Group 4) and 48.6 ± 7.3O from 14-14+6 weeks (Group 5). Groups 1 and 2 were significantly different to each other and all other groups (p
*
Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology,
University of Alberta, Edmonton, Alberta, Canada †
Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta,
Canada; Women’s & Children’s Health Research Institute, Mazankowski Alberta Heart Institute Current affiliations: L Howley, Pediatric Cardiology, Children’s Hospital Colorado, University of Colorado, Aurora, Colorado, USA; Y Yamamoto, Obstetrics & Gynecology, Juntendo University School of Medicine, Tokyo, Japan; P Sekar, Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Corresponding author: Dr L.K. Hornberger, Pediatric Cardiology, Stollery Children's Hospital, WMC 4C1.19 8440 - 112 Street, Edmonton, Alberta, Canada, T6G 2B7 Email: [email protected]; Telephone: 001 780 4073355, Fax: 001 780 4073954 Keywords: fetal heart, axis, first trimester, fetal echocardiography, reference values, cardiac development
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/uog.12478 Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
This article is protected by copyright. All rights reserved
Abstract
Objectives: This study aimed to document the changes in the normal embryonic/fetal cardiac axis in the late first and early second trimester of pregnancy. Methods: Images from 188 fetal echocardiograms performed prospectively between 8 and 15 weeks gestation in 166 healthy pregnancies and in 10 with severe fetal heart disease were reviewed. For each echocardiogram, three measurements of the cardiac axis were taken in the axial plane at the level of the four chamber view. One-way analysis of variance followed by Tukey’s multiple comparison test were used to compare differences in mean embryonic/fetal cardiac axis at different gestational ages in the healthy pregnancies. For paired results, the embryonic/fetal cardiac axis change was compared using Wilcoxon signed-rank testing Results: The mean embryonic/fetal cardiac axis was 25.5 ±11.5O from 8-9+6 weeks (Group 1), 40.4 ±9.2O from 10-11+6 weeks (Group 2), 49.2 ±7.4O from 12-12+6 weeks (Group 3), 50.6 ± 5.7O from 13-13+6 weeks (Group 4) and 48.6 ± 7.3O from 14-14+6 weeks (Group 5). Groups 1 and 2 were significantly different to each other and all other groups (p
