Fetal echocardiographic screening for congenital heart disease: the importance of the four-chamber view

Am J Obstet Gynecol. 1987 Sep;157(3):648-55. doi: 10.1016/s0002-9378(87)80022-4.


The four-chamber view of the heart has been proposed as a screening method for obstetrical sonographers to assess the fetus for the presence of congenital heart disease. We examined the fetuses in 1022 pregnancies and found 74 structurally abnormal hearts. Seventy-one of these (96%) were found to have an abnormality as seen in the four-chamber view. The four-chamber view of the heart had 92% sensitivity and 99.7% specificity in the detection of congenital heart disease. The positive predictive value was 95.8%, and the negative predictive value was 99.4%. We conclude that the four-chamber view may be a useful screen for the presence of congenital heart disease and should be included as a part of all routine obstetric ultrasound examinations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Echocardiography / methods*
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Fetal Diseases / diagnosis*
  • Fetal Heart / pathology*
  • Heart Defects, Congenital / diagnosis*
  • Humans
  • Pregnancy
  • Prenatal Diagnosis*
  • Risk