Five Transverse View of the Fetal Heart
In 2013, The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) published updated practice guidelines for screening of the fetal heart, suggesting early detection rates can be optimized by performing a thorough examination of the fetal
heart by complementing the four-chamber view with the outflow tract views in the cardiac screen, thus totaling five transverse views.
This recommendation supports the educational outreach and sonographer training program led by Helena Gardiner, M.D., Ph.D.
Understanding the five transverse views
The image is representative of the five axial views for optimal fetal heart screening. The color image shows the trachea (Tr), heart and great vessels, liver and stomach, with the five planes of insonation indicated by polygons corresponding to the gray-scale images, as indicated.
Image provided by the International Society of Ultrasound in Obstetrics and Gynecology. 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
- Most caudal plane, showing the fetal stomach (St),
cross-section of the descending aorta (dAo), spine
(Sp) and liver (Li).
- Four-chamber view of the fetal heart, showing the
right and left ventricles (RV, LV) and atria (RA, LA),
foramen ovale (FO) and pulmonary veins (PV) to the
right and left of the dAo.
- Left ventricular outflow tract view, showing the aortic
root (Ao), LV, RV, LA and RA and a cross-section of
- Slightly more cephalad view (right ventricular outflow
tract view) showing the main pulmonary artery (MPA)
and the bifurcation into the right (RPA) and left (LPA)
pulmonary arteries and cross-sections of the
ascending aorta (Ao) and dAo aorta.
- Three vessels and trachea view showing the superior
vena cava (SVC), pulmonary artery (PA), ductus
arteriosus (DA), transverse aortic arch (from proximal
Ao to dAo) and trachea (Tr). IVC, inferior vena cava;
L, left; R, right. Modified with permission from
Yagel et al.