Advancements in prenatal diagnosis and management of hypoplastic left heart syndrome: A multidisciplinary approach and future directions

Figure 2 Insonation planes for fetal cardiac assessment using fetal ultrasound[19,20]. Adapted under authorization from Carvalho et al[19] and Yagel et al[20]. Citation: Carvalho JS, Axt-Fliedner R, Chaoui R, Copel JA, Cuneo BF, Goff D, Gordin Kopylov L, Hecher K, Lee W, Moon-Grady AJ, Mousa HA, Munoz H, Paladini D, Prefumo F, Quarello E, Rychik J, Tutschek B, Wiechec M, Yagel S. ISUOG Practice Guidelines (updated): fetal cardiac screening. Ultrasound Obstet Gynecol 2023; 61: 788-803. Copyright© 1999-2025 published by John Wiley & Sons, Inc or related companies. Citation: Yagel S, Cohen SM, Achiron R. Examination of the fetal heart by five short-axis views: a proposed screening method for comprehensive cardiac evaluation. Ultrasound Obstet Gynecol 2001; 17: 367-369. Copyright© 1999-2025 published by John Wiley & Sons, Inc or related companies. The diagram illustrates the trachea, heart and major vessels, liver, and stomach, with five insonation planes indicated by polygons, corresponding to grayscale images as shown. I: The most caudal plane depicts the fetal stomach, cross-section of the descending aorta (dAo), inferior vena cava, spine, and liver; II: The four-chamber view of the fetal heart shows the right and left ventricles and atria, the foramen ovale, and pulmonary veins on either side of the dAo; III: The left ventricular outflow tract view includes the proximal ascending aorta, right and left ventricles, right and left ventricles and atria, and cross-section of the dAo; IV: A slightly more cephalad view, the right ventricular outflow tract view, reveals the main pulmonary artery and its bifurcation into the right and left pulmonary arteries, as well as cross-sections of the aorta and dAo; V: The three-vessel-and-trachea view shows the superior vena cava, main pulmonary artery, ductus arteriosus, transverse aortic arch (extending from the proximal aorta to the dAo), and trachea. St: Stomach; dAo: Descending aorta; IVC: Inferior vena cava; Sp: Spine; RV: Right ventricles; LV: Left ventricles; RA: Right atria; LA: Left atria; FO: Foramen ovale; PV: Pulmonary veins; Ao: Aorta; MPA: Main pulmonary artery; RPA: Right pulmonary arteries; LPA: Left pulmonary arteries; SVC: Superior vena cava; DA: Ductus arteriosus; Tr: Trachea.