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The Extended Fetal Cardiac Examination

Is It Feasible in a High-Risk Practice?

McGahan, John P., MD*; Cheang, Ellen C., MD*; Sekhon, Simran, MD*; Gerscovich, Eugenio O., MD*; James, Gina, BA, RDMS*†; Boe, Nina M., MD; Wilson, Machelle D., PhD

doi: 10.1097/RUQ.0000000000000367
Original Research

The aims of this study were to demonstrate the feasibility of obtaining additional cardiac views as proposed on an extended fetal cardiac examination and to see if there was any variation in individual components of that examination stratified by sonographer training, patient body habitus, or equipment. We retrospectively reviewed 200 consecutive detailed second-trimester high-risk fetal obstetric sonograms that included additional extended cardiac views. We analyzed the percentage of the time individual views were obtained, with variation based on (1) a sonographer with greater than 3 years of training compared with a group with 6 to 12 months of training, (2) 2 different ultrasound units, and (3) different body mass indices. Overall, the highest rate of visualization was achieved with the 4-chamber view (98.2%), whereas the 3-vessel tracheal view had the lowest percentage of visualization (40.2%), among the less experienced sonographers. Differences in successful completion of the extended cardiac views were not statistically different between the sonographer with a level of training greater than 3 years as compared with those with 6 to 12 months' training except for the 3-vessel tracheal view (P < 0.001). There is no statistically significant difference in our ultrasound equipment, when considering only inexperienced sonographers. Increasing body mass index had an inverse relationship with obtaining the components of the detailed cardiac examination. Using state-of-the-art ultrasound equipment and with focused additional training of obstetric sonographers, the majority of extended cardiac views can be obtained. There are exceptions.

Departments of *Radiology and

Obstetrics and Gynecology, University of California Davis Medical Center; and

Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, School of Medicine, Sacramento, CA.

Received for publication February 12, 2018; accepted April 11, 2018.

The authors declare no conflict of interest.

The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (grant UL1 TR001860). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Address correspondence to: John P. McGahan, MD, University of California Davis Medical Center, Radiology Department, 4860 Y Street, Suite 3100, Sacramento, CA 95817 (e-mail:

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