'Assisted' Reshaping of the Fetal Heart?
Dramatic developments in medical imaging technologies over the last forty years mean we can now collect unprecedented amounts of information on cardiac and vascular structure and function. Fetal cardiac imaging, because of its requirement to image hearts on a very small scale, while coping with both unpredictable movement and a rapid pulse rate, has provided the extreme test of these emerging technologies. During this period, there has been a similarly unprecedented technical evolution in medical care of the earliest stages of life. Three major developments have been the emergence of assisted reproduction technologies in the late 1970s1, dramatic reductions in maternal and offspring mortality following pregnancy complications and the routine survival of infants, born prematurely, from very early in pregnancy2. This has resulted in a cohort of individuals, now entering adult life, whose embryonic, fetal and neonatal cardiovascular development occurred within a unique perinatal environment. The implications for the long term health of these offspring have only recently started to be considered. Fortuitously, the parallel technical advances in imaging over this time provide us with the tools to deliver insights into the issue.
- Received August 21, 2013.
- Accepted August 22, 2013.