Child health: Unrivalled images of the fetal heart through 3D reconstructions

New MRI techniques to image the fetal heart are currently being developed at Evelina London Children’s Hospital, in collaboration with King’s College London and the iFind project.

These techniques, unique to King’s Health Partners, correct fetal motion to allow for detailed 3D reconstructions of the fetal heart whilst still in the womb, even when just a few centimetres in size. The scans can then be used to definitively diagnose any suspected cardiac condition, allowing a more accurate after care plan to be created once the baby is born.

These reconstructions have provided unrivalled images of the fetal heart and its vessels to plan care after birth. By combining these images with other advanced ultrasound and MRI methods to measure blood flow through the heart and lungs, the developing brain, and the placenta, a uniquely detailed anatomical and physiological profile of fetal cardiovascular systems can be generated for each patient.

In addition, ethical approval is now in place to couple these methods with other novel non-invasive diagnostic tests and potential therapeutic approaches, such as maternal hyper-oxygenation.

These new techniques have an immediate clinical impact for conditions which have traditionally been difficult to diagnose before birth, such as coarctation of the aorta, right aortic arch, and some forms of hypoplastic left heart syndrome, and are already helping to better inform pre- and postnatal management in some cases. To date the service has received nearly 100 referrals from within Guy’s and St Thomas’ and from other centres around the UK.

Our aim is to use these new methods not only to aid the antenatal diagnosis of severe congenital heart disease, but also, through close collaboration with both our fetal medicine colleagues and researchers at the Centre for the Developing Brain, to better understand how fetal and placental circulation can affect other aspects of long-term health, such as brain growth, neurodevelopment and long-term cardiovascular health.