Detection of congenital heart disease in the first trimester of pregnancy

In this chapter we review the current status of early detection of congenital heart disease in the first trimester of pregnancy. There is an increasing demand for earlier diagnosis of congenital heart disease. Early fetal echocardiography is feasible and there are a number of complex diagnoses that can be made in early pregnancy. At present a follow-up second trimester ultrasound is required in all cases of on-going pregnancies. Early fetal echocardiography should be considered for fetuses at risk. For fetuses with an increased NT measurement, early fetal echocardiography should be reserved for those with a normal karyotype. Routine screening for structural heart disease should continue to be performed in the second trimester. Programs specializing in the early diagnosis of congenital heart disease should be confined to a small number of highly specialized institutions.