Micro-computed tomography of isolated fetal hearts following termination of pregnancy: a feasibility study at 8 - 12 week's gestation

OBJECTIVES: To assess the feasibility of retrieval of intact human fetal hearts after first trimester surgical termination of pregnancy (TOP) and subsequent anatomical assessment by postmortem micro-computed tomography (micro-CT). METHODS: In a cohort of consenting women undergoing surgical TOP between 8 and 13 weeks' gestation, we attempted the retrieval of the fetal heart from the suction material. Specimens were immersion fixed in 10% formaldehyde, scanned by Iodine enhanced micro-CT and cardiac anatomy assessed by a multidisciplinary team using 3D-multiplanar analysis. RESULTS: The median gestational age at TOP was 10.7weeks (range 8.3-12.9). In 57 (95.0%) out of 60 suction specimens, the heart could be retrieved. The median cardiac length was 5mm (range 2-8mm), in three (5.3%), the heart was too damaged to assess cardiac anatomy and in five (8.7%) only the four chambers could be examined. In the remaining 49 (86.0%) cases, a detailed assessment of cardiac anatomy was possible, showing a major defect in two (4.1%) and a minor defect in four (8.2%). CONCLUSIONS: Fetal hearts can be retrieved after first trimester TOP being intact in the vast majority of cases. Iodine enhanced, post-mortem micro-CT can be used to assess cardiac anatomy from as early as 8 weeks and to describe heart abnormalities. This article is protected by copyright. All rights reserved