Cardiac disease in pregnancy echocardiography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief:Lakshmi Gopalakrishnan, M.B.B.S. [2]

Echocardiograhy does not carry the risk of fetal irradiation and it is a safe and preferred screening method to assess cardiac function and valvular lesions in the pregnant patient.

• There is a progressive increase in chamber dimension with:

• ~20% increase in the size of the right atrium and the right ventricle,
• ~12% increase in left atrial size, and
• ~6% increase in left ventricular size.

• Following delivery, the above changes gradually return to their pre-gestational baseline size.

• In addition, there is early and progressive dilation of the mitral, tricuspid, and pulmonary annuli which is associated with an increase in valvular regurgitation.

Fetal echocardiography is 96% sensitive in detecting major structural malformations (72/74 abnormalities identified among 1,022 fetuses) and is useful for genetics counseling and management during pregnancy and postpartum.

• Pregnant women at high-risk for structural heart disease with:

• History of congenital heart disease themselves or in previous children.
• Presence of diabetes or collagen vascular disease– predisposing factor for congenital heart disease.

• History of a fetal arrhythmia
• Consumption of teratogens

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