Free Fetal Echocardiography Knowledge Quiz (2025)

Which sonographic view is optimal for visualizing the atrial and ventricular septa in fetal echocardiography?

Four-chamber view

Outflow tract view

Short-axis view

Subcostal view

The four-chamber view clearly shows both atria and ventricles and their septa. It is the primary screening view for septal integrity in the fetal heart.

In the left ventricular outflow tract (LVOT) view, which structure is visualized leaving the left ventricle?

Aorta

Pulmonary artery

Mitral valve

Tricuspid valve

The LVOT view displays the aorta as it arises from the left ventricle. Identifying the aorta in this view helps assess position and caliber.

During what gestational age range is fetal echocardiography typically performed for optimal heart evaluation?

18 - 22 weeks

6 - 8 weeks

28 - 32 weeks

12 - 14 weeks

Fetal echocardiography is optimally performed between 18 and 22 weeks when cardiac structures are well developed. Earlier or later exams are less informative for certain anomalies.

What is the normal resting fetal heart rate range on ultrasound?

160 - 180 bpm

120 - 160 bpm

100 - 120 bpm

80 - 100 bpm

A normal fetal heart rate ranges from 120 to 160 beats per minute. Rates outside this range may suggest arrhythmia or distress.

Which Doppler mode is primarily used to measure the velocity of blood flow in fetal cardiac vessels?

3D Doppler

M-mode

Pulsed wave Doppler

Color Doppler

Pulsed wave Doppler places a sample volume in a vessel to measure peak and mean flow velocities. It is standard for quantitative assessment of fetal cardiac flow.

Which measurement assesses fetal cardiac size relative to thoracic dimensions?

Cardiothoracic ratio

Femur length

Crown-rump length

Nuchal fold thickness

The cardiothoracic ratio compares the cardiac area to the thoracic area on an axial view. A ratio below 0.5 is considered normal.

What is the normal upper limit for the fetal cardiothoracic ratio?

0.75

1.0

0.25

0.5

A normal fetal cardiothoracic ratio is less than or equal to 0.5. Ratios above this value suggest cardiomegaly.

When using pulsed Doppler to assess mitral inflow, where is the sample volume placed?

At the interventricular septum

Inside the left atrium

In the left ventricular outflow tract

At the tip of the mitral valve leaflets

The sample volume is placed at the tips of the mitral leaflets to capture early (E) and late (A) diastolic filling velocities. This helps evaluate ventricular diastolic function.

Which prenatal ultrasound finding is characteristic of pulmonary atresia?

Pericardial effusion

Absence of right ventricular outflow tract flow

Enlarged left ventricle

Thickened atrial septum

Pulmonary atresia is defined by absence of flow through the pulmonary valve and right ventricular outflow. It results in underdeveloped pulmonary arteries.

An increased peak systolic velocity in the middle cerebral artery on Doppler suggests which fetal condition?

Anemia

Polycythemia

Hydrocephalus

Hypothyroidism

Elevated MCA peak systolic velocity indicates reduced blood viscosity from anemia. This is a noninvasive marker for fetal anemia.

Which anomaly presents with 'parallel' great vessels on the outflow tract views?

Transposition of the great arteries

Tetralogy of Fallot

Truncus arteriosus

Coarctation of the aorta

In transposition of the great arteries, aorta and pulmonary artery run parallel instead of crossing. This abnormal relationship is diagnostic.

Which M-mode parameter assesses fetal ventricular systolic function?

Fractional shortening

A-wave reversal

Tricuspid regurgitation velocity

Peak E velocity

Fractional shortening measures the percentage change in ventricular diameter between diastole and systole. It reflects contractile performance.

On color Doppler, a ventricular septal defect is identified by which feature?

Jet crossing the ventricular septum

High-velocity flow in the aorta

Flow along the atrial septum

Absent color signal

A VSD appears as a colored jet traversing the septum due to pressure difference. The location and size help determine hemodynamic significance.

Maternal diabetes is most strongly associated with which fetal cardiac abnormality?

Ebstein anomaly

Truncus arteriosus

Hypoplastic left heart syndrome

Hypertrophic cardiomyopathy

Poorly controlled maternal diabetes can cause fetal myocardial hypertrophy. This leads to septal and ventricular wall thickening.

Which transverse view shows the right ventricular outflow tract, aortic arch, and superior vena cava?

Short-axis view

Three-vessel view

Apical four-chamber view

Subxiphoid view

The three-vessel view displays pulmonary artery, aorta, and superior vena cava in cross-section. It assesses relative size and alignment.

Which ultrasound feature is diagnostic for Ebstein anomaly in the fetus?

Overriding aorta

Apical displacement of tricuspid valve leaflets

Hypoplastic right ventricle

Absent pulmonary valve

Ebstein anomaly is defined by apical displacement of the septal and posterior tricuspid leaflets into the right ventricle. This causes atrialization of part of the ventricle.

A reversed A-wave in the ductus venosus Doppler trace indicates which fetal condition?

Mild pulmonary stenosis

Normal cardiac compliance

Atrial septal defect

Increased cardiac preload and dysfunction

Reversal of the A-wave reflects elevated right atrial pressure and impaired ventricular compliance. It is a marker of significant cardiac dysfunction.

In fetal echocardiography, z-scores are used to normalize cardiac measurements to what parameter?

Maternal age

Fetal heart rate

Gestational age and fetal size

Placental thickness

Z-scores standardize measurements for gestational age and overall fetal size. They allow comparison to normative data and detection of abnormal growth.

Maternal autoimmune conditions like lupus predispose the fetus to which cardiac finding?

Congenital heart block

Transposition of the great arteries

Persistent truncus arteriosus

Tetralogy of Fallot

Maternal anti-Ro and anti-La antibodies can cross the placenta and damage the fetal conduction system, leading to congenital heart block.

Which 3D ultrasound technique allows dynamic volumetric assessment of the fetal heart?

B-flow imaging

Contrast-enhanced 3D

Power Doppler

Spatio-Temporal Image Correlation (STIC)

STIC acquires a volume dataset over time, enabling cine display of the beating fetal heart. It is valuable for complex structural analysis.