Normal fetal cardiac morphometric parameters reference across gestation

Normal fetal cardiac morphometric parameters reference across gestation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Normal fetal cardiac morphometric parameters reference across gestation Ashraf Anas Zytoon, Amr Mostafa Hezo, Belal Said Soltan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7068652/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Dec, 2025 Read the published version in Egyptian Journal of Radiology and Nuclear Medicine → Version 1 posted You are reading this latest preprint version Abstract Background Congenital heart disease (CHD) is a serious life-threatening medical condition in newborns with high rates of mortality. It is responsible for around fifty percent of total childhood deaths caused by birth defects so establishing the references for fetal normal cardiac morphometric parameters during various gestational ages is essential. Objective The aim of the current study was to propose standard references for fetal normal heart dimensions, main pulmonary artery (PA) and aorta (Ao) diameters as well as the PA/Ao ratio across gestation in the Egyptian population to boost the detection rate of CHD before birth since early diagnosis of CHD has showed remarkably better outcomes. Results Standard references were established for twenty-one fetal normal cardiac morphometric measurements including PA and aorta diameters, PA/Ao ratio by the three-vessel view in addition to cardiac dimensions of the heart and each chamber separately as well as myocardial wall thicknesses by the four-chamber view. All estimated measurements showed a progressive increase throughout different gestational ages. Both sides of the heart were nearly equal in size at early weeks of gestation however with advance of gestation the right-side chambers became slightly larger than the left-side ones. The PA was regularly larger than the aorta with approximately constant PA/Ao ratio across gestation. Conclusions Detection rate of CHD prenatally can be improved using simple screening methods during routine ultrasound scans. Our study has developed references for twenty-one cardiac parameters in normal local Egyptian fetuses from the 20th to the 38th week of gestation to enable early detection of any abnormal deviations. Congenital heart disease (CHD) PA/Ao ratio Four-chamber view (4CV) Pulmonary artery (PA) Three-vessel view (3VV) Aorta (Ao) Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Background Congenital heart disease (CHD) is a serious life-threatening medical condition in newborns with high mortality and leads to about fifty percent of the entire newborn deaths from congenital anomalies [ 1 , 2 ] . However fetal magnetic resonance imaging has the upper hand for different organs imagining with no risk of exposure to radiation, it’s of a low importance when it comes to cardiac imaging because of its sensitivity to motion. Hence, different imaging procedure such as ultrasound using the three-vessel and four-chamber views is a better option to evaluate and detect any cardiac chambers and outflow abnormalities [ 3 ] . Since early detected CHD cases have demonstrated higher survival rate through early recognition of the anomaly prenatally and saving time for early intervention through the possible surgical options postnatally to save lives. Enhancing CHD detection rates is a priority [ 4 , 5 ] . Regarding the knowledge that any abnormality of the fetal heart anatomy is compensated through remodeling pathway to overcome the flow disturbance inside the chambers as well as the main outflow vessels, and the ease and time saving ultrasound sections such as the three-vessel and four-chamber views. Any cardiac anomaly will be early manifested by deviation from the normal ranges of the cardiac measurements [ 6 , 7 , 8 ] . The goal of the present study was to construct those reference ranges for the fetal normal heart at different gestational ages to help detect any deviation from normality. The three-vessel view was obtained to measure the fetal PA and Ao diameters then the PA/Ao ratio was calculated. Furthermore, the four-chamber view was used to measure the remaining fetal cardiac dimensions. Finally, the measurements values for each gestational age in weeks were gathered and analyzed to establish the normal ranges of each parameter including the upper and lower bounds for every gestational age. Methods Study design Five hundred pregnant women with singleton pregnancies referred to our radiology department during the period time from January 2024 to January 2025 for their routine ultrasound examination were included in the study. Ethics statement All subjects included were informed and became familiar of the examination and its nature then voluntary applied for the study. Inclusion criteria Our study final statistical analysis only included the subjects with normal fetal morphology and anomaly scan results as well as accurate pregnancy dating through the last menstruation period and ultrasonographic measurements. Exclusion criteria The exclusion criteria were considered as follows: multiple pregnancies, fetal malformations, maternal hypertension, family history of congenital abnormalities, diabetes mellitus, pre-eclampsia, amniotic fluid index abnormalities as well as mismatching between gestational age calculated by the last menstruation period and obstetric ultrasound measurements. Equipment Ultrasonography images were acquired with real time ultrasound equipment at our department (LOGIQ P7 GE Healthcare Sonography Machine from General Electric Healthcare Technologies, Inc. Chicago, Illinois, United States) equipped with 2-5 MHz curvilinear transducer. Ultrasound image acquisition and orientation At first a routine obstetric ultrasound scan was performed and the fetal situs was defined. Afterwards, the four-chamber view (Fig. 1) was obtained through a transverse cut section across the fetal thorax just above the diaphragm, a true transverse cut section is confirmed with inspection of at least one rib on each side of the fetal chest wall. Subsequently, the entire heart, both ventricular dimensions as well as both ventricular and interventricular wall thicknesses were measured at their maximal size during end-diastole (Fig. 2) confirmed by fully dilatation of the ventricles during closure of the atrioventricular valves. While the atrial dimensions were obtained at their maximal size during end-systole (Fig. 3) confirmed by the frame prior to opening of the atrioventricular valves. (Figure 1) (Figure 2) (Figure 3) Cardiac transverse diameter was measured below the atrioventricular valves while its longitudinal diameter was measured from base till apex of the heart during end-diastole (Fig. 4) . (Figure 4) Both atrial transverse and longitudinal diameters were measured by the lines dividing the atria into four equivalent squares additionally their areas were measured too during end-systole (Fig. 5) . (Figure 5) Both ventricular transverse diameters were measured below the atrioventricular valves while their longitudinal diameters were measured from the atrioventricular valves level till ventricular apex likewise their areas were measured also during end-diastole (Fig. 6) . (Figure 6) Both ventricular wall as well as the interventricular septal wall thicknesses were measured during end-diastole (Fig. 7) . (Figure 7) Subsequently, the three-vessel view was obtained by sliding the transducer cranially while maintaining a transverse section of the fetal thorax. The PA, Ao as well as superior vena cava (SVC) are arranged in a straight line from left-anterior to right-posterior in mediastinum, respectively. The PA is the largest in size while the SVC is the smallest. Both PA and Ao diameters were measured by placing the calipers on the lines that define the vessel wall then the PA/Ao ratio was computed (Fig. 8) . (Figure 8) Statistical methods Results were collected, tabulated and statistically analyzed using IBM SPSS Statistics package program version 30.0 for Windows (IBM, Armonk, NY). Descriptive statistics methods were carried out in the form of graphical as well as numerical description techniques as follow: quantitative data were demonstrated in the form of mean ( ) ± standard deviation (SD) and range whereas qualitative data were represented as frequencies and relative frequencies. For graphical descriptive techniques we used bar chart as well as scatter diagram. Results Initially, 514 pregnancies were qualified for our study, 14 of them were excluded due to discordance in measurements (outliers). Eventually, a total of 500 subjects with normal singleton pregnancies of gestational age between 20 and 38 weeks (mean maternal age, 29.87; SD, 5.66) were included for the references construction as shown in Table 1 . Included subjects in the study had a gestational age ranged between 20 and 38 weeks, the mean estimated gestational age was 27.44 weeks with a standard deviation of ± 5.33 as detailed in Table 2 . Most of cases 9.6% were in 22 nd week of gestation, 9% in 21 st week, 8.4% in 25 th week, 7.6% in 24 th week, 6.8% in 36 th week, 6.6% in 28 th week, 6.4% in 34 th week, 6.2% in 30 th week, 5.8% in 20 th and 23 rd week, 5.6% in 29 th week, 4.4% in 35 th week, 3.8% in 27 th week, 3% in 33 rd week, 2.8% in 26 th week, 2.6% in 32 nd week, 2.2% in 31 st and 37 th week, and 1.2% in 38 th week of gestation as illustrated in Fig. 9 . (Figure 9) Scatter diagrams presented by each gestational age in weeks for the evaluated twenty-one fetal cardiac parameters such as PA diameter, Ao diameter, PA/Ao ratio, transverse and longitudinal diameters as well as area for the heart and for each chamber separately in addition to both ventricular and interventricular septal wall thicknesses also are shown in Fig. 10-14 and Tables 3-6 respectively. (Figure 10) (Figure 11) (Figure 12) (Figure 13) (Figure 14) Table 1 Demographic distribution of the participants Maternal age descriptive statistics Value Mean ( x̄) 29.87 Standard deviation (SD) ± 5.66 Minimal estimated maternal age 20 years Maximal estimated maternal age 39 years Table 2 Gestational age distribution Gestational age (GA) descriptive statistics Value Mean ( x̄) 27.44 Standard deviation (SD) ± 5.33 Minimal estimated gestational age 20 weeks Maximal estimated gestational age 38 weeks Table 3 Reference ranges for the fetal pulmonary artery and aorta diameters along with the PA/Ao ratio GA (weeks) No. of subjects PA diameter (mm) Mean (Range) Ao diameter (mm) Mean (Range) PA/Ao ratio Mean (Range) 20W 29 3.20 (2.91 - 3.50) 2.78 (2.54 - 3.03) 1.151 (1.141 - 1.166) 21W 45 3.49 (3.32 - 3.68) 3.03 (2.91 - 3.19) 1.153 (1.141 - 1.160) 22W 48 3.82 (3.58 - 4.06) 3.30 (3.09 - 3.52) 1.157 (1.118 - 1.167) 23W 29 4.07 (3.91 - 4.18) 3.51 (3.38 - 3.62) 1.158 (1.153 - 1.172) 24W 38 4.29 (4.10 - 4.46) 3.71 (3.54 - 3.89) 1.156 (1.140 - 1.167) 25W 42 4.54 (4.32 - 4.78) 3.91 (3.78 - 4.05) 1.160 (1.134 - 1.180) 26W 14 4.81 (4.62 - 4.98) 4.15 (3.98 - 4.31) 1.159 (1.153 - 1.167) 27W 19 5.13 (4.95 - 5.29) 4.37 (4.26 - 4.47) 1.173 (1.162 - 1.183) 28W 33 5.41 (5.24 - 5.59) 4.61 (4.43 - 4.77) 1.176 (1.163 - 1.183) 29W 28 5.65 (5.44 - 5.86) 4.82 (4.65 - 4.96) 1.174 (1.165 - 1.186) 30W 31 5.90 (5.72 - 6.13) 5.02 (4.86 - 5.19) 1.175 (1.153 - 1.184) 31W 11 6.21 (6.05 - 6.39) 5.28 (5.18 - 5.37) 1.176 (1.168 - 1.190) 32W 13 6.49 (6.34 - 6.65) 5.53 (5.37 - 5.67) 1.174 (1.165 - 1.181) 33W 15 6.76 (6.60 - 6.92) 5.73 (5.63 - 5.84) 1.178 (1.172 - 1.185) 34W 32 6.97 (6.86 - 7.09) 5.91 (5.80 - 6.02) 1.180 (1.176 - 1.184) 35W 22 7.24 (7.05 - 7.41) 6.19 (6.06 - 6.33) 1.169 (1.162 - 1.178) 36W 34 7.57 (7.41 - 7.75) 6.44 (6.30 - 6.58) 1.176 (1.166 - 1.180) 37W 11 7.83 (7.66 - 7.98) 9.91 (6.49 - 6.72) 1.184 (1.180 - 1.190) 38W 6 8.02 (7.87 - 8.15) 6.77 (6.64 - 6.87) 1.184 (1.180 - 1.186) Table 4 Reference ranges for fetal cardiac transverse and longitudinal dimensions as well as the cardiac area along with ventricular and interventricular septal wall thicknesses GA (weeks) No. of subjects Cardiac transverse diameter (mm) Mean (Range) Cardiac longitudinal diameter (mm) Mean (Range) Cardiac area (mm 2 ) Mean (Range) Left ventricular wall thickness (mm) Mean (Range) Right ventricular wall thickness (mm) Mean (Range) Septal wall thickness (mm) Mean (Range) 20W 29 16.58 (15.88 - 17.27) 20.85 (19.77 - 21.93) 267.9 (243.17 - 293.35) 1.11 (0.90 - 1.30) 1.08 (0.90 - 1.26) 1.05 (0.89 - 1.19) 21W 45 18.14 (16.93 - 19.35) 22.46 (20.98 - 23.94) 316.41 (275.41 - 359.17) 1.40 (1.27 - 1.53) 1.32 (1.23 - 1.42) 1.23 (1.14 - 1.32) 22W 48 19.92 (18.51 - 21.36) 23.37 (21.11 - 25.66) 372.12 (312.45 - 436.85) 1.53 (1.38 - 1.67) 1.46 (1.32 - 1.57) 1.37 (1.27 - 1.46) 23W 29 21.03 (19.18 - 22.89) 25.77 (24.08 - 27.46) 452.52 (384.79 - 523.68) 1.70 (1.61 - 1.80) 1.59 (1.51 - 1.68) 1.49 (1.41 - 1.58) 24W 38 22.68 (20.73 - 24.59) 26.97 (25.14 - 28.89) 498.15 (424.04 - 578.01) 1.84 (1.75 - 1.94) 1.71 (1.64 - 1.79) 1.62 (1.53 - 1.72) 25W 42 23.43 (21.85 - 25.13) 29.40 (27.93 - 30.92) 575.04 (508.74 - 647.75) 1.97 (1.88 - 2.07) 1.82 (1.75 - 1.88) 1.75 (1.66 - 1.96) 26W 14 24.95 (22.97 - 26.92) 30.97 (29.10 - 32.83) 645.11 (557.22 - 736.75) 2.14 (2.04 - 2.22) 1.94 (1.85 - 2.01) 1.88 (1.80 - 1.95) 27W 19 26.15 (23.77 - 28.52) 31.92 (29.95 - 33.89) 697.15 (593.47 - 805.74) 2.27 (2.16 - 2.38) 2.07 (1.98 - 2.15) 2.02 (1.92 - 2.11) 28W 33 26.78 (24.25 - 29.46) 32.44 (30.32 - 34.68) 777.59 (656.50 - 912.23) 2.41 (2.31 - 2.50) 2.13 (2.02 - 2.24) 2.17 (2.07 - 2.25) 29W 28 29.96 (27.47 - 32.58) 35.57 (33.65 - 37.60) 860.05 (743.77 - 987.68) 2.55 (2.45 - 2.66) 2.29 (2.21 - 2.39) 2.28 (2.18 - 2.37) 30W 31 33.01 (29.97 - 35.94) 35.53 (33.21 - 38.04) 923.94 (783.70 - 1076.49) 2.69 (2.59 - 2.79) 2.41 (2.33 - 2.49) 2.39 (2.31 - 2.48) 31W 11 33.23 (30.34 - 36.11) 38.81 (36.24 - 41.45) 1017.86 (865.76 - 1178.62) 2.85 (2.74 - 2.95) 2.54 (2.47 - 2.60) 2.53 (2.44 - 2.61) 32W 13 34.12 (31.25 - 36.68) 40.84 (37.45 - 44.65) 1058.44 (886.39 - 1240.43) 2.98 (2.88 - 3.07) 2.65 (2.58 - 2.72) 2.65 (2.56 - 2.73) 33W 15 34.84 (32.33 - 36.86) 42.60 (38.29 - 47.11) 1126.95 (932.20 - 1315.19) 3.13 (3.03 - 3.21) 2.77 (2.69 - 2.84) 2.79 (2.69 - 2.87) 34W 32 35.98 (32.82 - 38.96) 44.45 (39.64 - 49.27) 1284.66 (1041.46 - 1536.64) 3.27 (3.17 - 3.36) 2.88 (2.80 - 2.96) 2.92 (2.83 - 2.99) 35W 22 37.08 (34.66 - 39.43) 46.98 (43.23 - 50.48) 1392.53 (1195.66 - 1588.33) 3.42 (3.32 - 3.51) 2.98 (2.91 - 3.05) 3.07 (3.01 - 3.12) 36W 34 38.71 (36.26 - 41.16) 48.91 (45.44 - 52.04) 1519.12 (1316.59 - 1689.88) 3.55 (3.46 - 3.63) 3.09 (3.00 - 3.25) 3.16 (3.07 - 3.25) 37W 11 39.08 (36.59 - 41.56) 49.61 (46.82 - 52.12) 1551.19 (1368.93 - 1730.88) 3.69 (3.59 - 3.78) 3.22 (3.13 - 3.29) 3.29 (3.19 - 3.37) 38W 6 40.34 (37.86 - 42.82) 50.81 (48.87 - 52.47) 1639.54 (1478.46 - 1795.33) 3.80 (3.73 - 3.87) 3.36 (3.27 - 3.48) 3.45 (3.33 - 3.56) Table 5 Reference ranges for fetal both atrial transverse and longitudinal dimensions along with the atrial areas GA (weeks) No. of subjects Left atrial transverse diameter (mm) Mean (Range) Left atrial longitudinal diameter (mm) Mean (Range) Left atrial area (mm 2 ) Mean (Range) Right atrial transverse diameter (mm) Mean (Range) Right atrial longitudinal diameter (mm) Mean (Range) Right atrial area (mm 2 ) Mean (Range) 20W 29 6.53 (5.62 - 7.37) 6.40 (5.50 - 7.39) 38.79 (28.32 - 48.69) 6.87 (5.97 - 7.78) 6.32 (5.49 - 7.23) 38.91 (29.45 - 48.11) 21W 45 7.12 (6.21 - 7.98) 7.07 (6.02 - 8.13) 49.19 (37.05 - 61.36) 7.63 (6.54 - 8.72) 7.05 (5.90 - 8.22) 49.80 (37.42 - 62.47) 22W 48 7.8 (7.15 - 8.74) 8.08 (6.75 - 9.98) 60.06 (46.81 - 72.98) 9.36 (7.35 - 9.35) 7.88 (6.48 - 9.22) 60.85 (46.21 - 73.70) 23W 29 8.32 (7.37 - 9.16) 8.29 (7.40 - 9.30) 68.32 (54.65 - 82.59) 8.73 (7.56 - 9.69) 8.37 (7.07 - 9.68) 69.30 (56.93 - 83.79) 24W 38 8.75 (7.66 - 9.72) 8.65 (7.11 - 10.1) 79.24 (62.45 - 97.57) 9.00 (8.03 - 10.01) 8.74 (7.18 - 10.31) 80.96 (63.57 - 99.25) 25W 42 9.23 (8.12 - 10.32) 9.53 (8.27 - 10.69) 87.31 (62.73 - 112.97) 9.90 (8.16 - 11.58) 9.49 (8.34 - 10.68) 88.62 (63.68 - 114.69) 26W 14 9.87 (8.72 - 11.12) 10.04 (8.75 - 11.33) 100.95 (76.27 - 125.62) 10.45 (8.68 - 12.21) 10.32 (8.76 - 11.88) 102.53 (77.97 - 127.09) 27W 19 10.55 (9.15 - 11.94) 10.55 (9.18 - 11.89) 111.3 (86.32 - 136.27) 11.2 (10.13 - 12.27) 10.94 (9.39 - 12.48) 113.45 (87.67 - 140.48) 28W 33 10.86 (9.67 - 12.11) 11.08 (9.46 - 12.56) 121.38 (92.37 - 148.35) 11.73 (10.57 - 12.92) 11.28 (9.74 - 12.83) 124.01 (96.56 - 152.87) 29W 28 11.39 (10.11 - 12.73) 11.77 (10.14 - 13.26) 131.13 (101.93 - 162.87) 11.95 (10.65 - 13.31) 11.75 (10.17 - 13.26) 134.00 (102.85 - 165.26) 30W 31 11.77 (10.27 - 13.31) 12.16 (10.39 - 13.82) 142.2 (111.37 - 174.21) 12.22 (10.72 - 13.69) 12.50 (10.86 - 14.11) 145.3 (112.28 - 178.65) 31W 11 12.29 (10.86 - 13.77) 12.57 (10.89 - 14.23) 152.68 (118.85 - 186.38) 12.77 (11.17 - 14.36) 12.70 (11.08 - 14.32) 155.45 (122.74 - 190.05) 32W 13 12.86 (11.24 - 14.55) 13.04 (11.34 - 14.83) 163.14 (126.58 - 200.67) 13.28 (11.59 - 14.97) 13.16 (11.49 - 14.83) 166.14 (129.33 - 203.44) 33W 15 13.19 (11.53 - 14.78) 13.21 (11.46 - 14.96) 173.49 (134.64 - 213.56) 13.39 (11.67 - 15.11) 13.41 (11.61 - 15.21) 177.06 (138.03 - 217.83) 34W 32 13.59 (12.03 - 15.18) 13.73 (11.83 - 15.59) 183.21 (142.88 - 224.39) 13.73 (11.92 - 15.51) 13.65 (11.78 - 15.45) 186.90 (145.74 - 228.22) 35W 22 14.09 (12.01 - 16.35) 14.33 (12.28 - 16.33) 193.46 (148.75 - 239.46) 14.45 (12.59 - 16.40) 14.71 (12.78 - 16.66) 197.90 (152.62 - 244.64) 36W 34 14.95 (13.52 - 16.29) 15.79 (13.45 - 17.93) 206.17 (158.47 - 250.68) 15.11 (13.32 - 16.83) 15.66 (13.82 - 17.36) 210.12 (160.91 - 256.01) 37W 11 16.31 (14.86 - 17.84) 16.46 (14.75 - 18.17) 211.52 (169.85 - 243.68) 16.06 (14.30 - 17.83) 16.29 (14.84 - 17.73) 214.18 (169.34 - 246.40) 38W 6 16.64 (15.17 - 18.11) 16.83 (15.13 - 18.53) 224.13 (173.79 - 270.40) 16.67 (15.09 - 18.24) 16.64 (15.10 - 18.17) 228.34 (178.64 - 272.79) Table 6 Reference ranges for fetal both ventricular transverse and longitudinal dimensions along with the ventricular areas GA (weeks) No. of subjects Left ventricular transverse diameter (mm) Mean (Range) Left ventricular longitudinal diameter (mm) Mean (Range) Left ventricular area (mm 2 ) Mean (Range) Right ventricular transverse diameter (mm) Mean (Range) Right ventricular longitudinal diameter (mm) Mean (Range) Right ventricular area (mm 2 ) Mean (Range) 20W 29 5.77 (4.81 - 6.73) 12.10 (10.33 - 13.76) 65.71 (46.31 - 86.31) 5.85 (4.66 - 6.77) 10.62 (8.71 - 12.51) 58.31 (37.83 - 78.93) 21W 45 6.53 (5.49 - 7.49) 13.22 (11.35 - 14.98) 83.36 (60.38 - 107.55) 6.43 (5.38 - 7.48) 11.97 (10.32 - 13.44) 77.17 (55.28 - 100.1) 22W 48 7.16 (6.05 - 8.35) 14.34 (12.59 - 15.96) 100.85 (74.51 - 130.37) 7.41 (6.06 - 8.92) 13.12 (10.58 - 15.83) 96.12 (62.72 - 138.13) 23W 29 7.75 (6.63 - 8.87) 15.35 (13.14 - 17.56) 116.30 (84.46 - 151.04) 7.79 (6.66 - 8.92) 14.64 (13.07 - 16.21) 110.72 (84.41 - 140.27) 24W 38 8.30 (7.06 - 9.57) 15.67 (12.95 - 18.63) 111.99 (77.89 - 151.97) 8.38 (7.21 - 9.64) 14.60 (12.49 - 16.88) 109.09 (79.72 - 144.15) 25W 42 8.90 (7.72 - 10.15) 16.21 (12.89 - 19.15) 128.95 (88.03 - 171.91) 8.99 (7.25 - 10.32) 15.33 (12.95 - 17.62) 128.56 (92.87 - 168.44) 26W 14 9.53 (8.44 - 10.75) 18.20 (16.08 - 20.30) 154.41 (120.09 - 192.99) 9.61 (8.35 - 10.88) 16.17 (13.85 - 18.76) 145.14 (107.06 - 185.79) 27W 19 10.02 (8.79 - 11.39) 19.06 (16.77 - 21.35) 170.10 (130.32 - 215.08) 10.16 (8.79 - 11.55) 16.97 (14.46 - 19.48) 161.06 (117.74 - 206.90) 28W 33 10.53 (9.08 - 12.11) 19.74 (17.08 - 22.40) 186.50 (138.19 - 241.74) 10.71 (9.09 - 12.31) 18.71 (16.84 - 20.58) 182.26 (138.42 - 229.04) 29W 28 11.00 (9.54 - 12.42) 20.38 (17.32 - 23.22) 206.39 (151.10 - 263.71) 11.22 (9.66 - 12.60) 19.86 (17.21 - 22.57) 198.44 (147.17 - 251.71) 30W 31 11.61 (9.78 - 13.46) 21.56 (18.64 - 24.37) 230.78 (166.58 - 299.7) 11.75 (10.11 - 13.40) 20.76 (18.11 - 23.16) 224.44 (167.29 - 283.55) 31W 11 11.82 (10.22 - 13.52) 22.19 (19.54 - 24.63) 241.33 (182.46 - 304.25) 12.10 (10.35 - 13.72) 21.95 (19.76 - 24.20) 244.19 (186.86 - 303.36) 32W 13 12.19 (10.48 - 13.98) 23.00 (20.24 - 25.76) 257.98 (193.80 - 329.03) 12.54 (10.98 - 14.11) 22.45 (19.93 - 24.97) 258.78 (199.94 - 321.91) 33W 15 12.54 (10.78 - 14.32) 23.69 (20.68 - 26.46) 273.39 (203.68 - 346.19) 12.93 (11.23 - 14.58) 23.14 (20.76 - 25.51) 274.75 (213.01 - 339.83) 34W 32 13.04 (11.25 - 14.74) 24.30 (21.38 - 26.97) 302.71 (228.73 - 377.87) 13.26 (11.47 - 14.98) 23.87 (21.25 - 26.41) 300.56 (230.59 - 374.13) 35W 22 13.50 (11.94 - 15.05) 25.05 (21.89 - 28.22) 312.21 (240.14 - 390.08) 13.64 (11.86 - 15.64) 24.35 (21.38 - 27.38) 310.98 (236.03 - 398.61) 36W 34 14.52 (12.48 - 16.47) 25.85 (22.29 - 28.87) 328.63 (241.85 - 413.39) 14.81 (12.87 - 16.62) 25.78 (22.35 - 28.82) 333.15 (250.11 - 416.44) 37W 11 14.66 (12.66 - 16.63) 26.31 (22.91 - 29.23) 345.61 (257.96 - 432.34) 14.97 (13.28 - 16.58) 25.92 (22.67 - 29.30) 347.15 (267.76 - 432.07) 38W 6 14.78 (12.82 - 16.80) 26.97 (23.46 - 30.41) 357.52 (267.50 - 454.39) 15.08 (13.29 - 16.66) 27.07 (23.85 - 30.28) 365.19 (281.91 - 448.67) Discussion Congenital heart disease (CHD) is considered the most prevalent congenital anomaly among newborns. It is a serious life-threatening medical condition in newborns with high mortality rates in nearly twenty-five percent of the affected babies [9] . In respect of the necessity for urgent postnatal medical and surgical interventions for some cases, early detection of CHD before birth will give a significant chance of timely treatment for better outcomes and higher survival rates [10] . Regarding the knowledge that any abnormality of the fetal heart anatomy is compensated through remodeling pathway to adapt and overcome the disturbance inside the chambers as well as the main outflow vessels. Any CHD will be associated with abnormal changes in the size and structure of the heart [11, 12] . With the help of the ultrasound during routine antenatal scans, our current study provides standard references for fetal normal cardiac morphometric parameters during various gestational ages. Any deviation of these measurements should raise the possibility of an underlying congenital cardiac anomaly. Which will enhance the sensitivity of antenatal diagnosis of CHD [13] . This study was carried on five hundred normal singleton pregnancies from the 20 th to the 38 th week of gestation (mean GA, 27.44; SD, 5.33). In the present study, our references involved twenty-one fetal cardiac parameters including diameters of both the great vessels of the heart arising from the ventricles, the PA/Ao ratio, the whole heart length, width and area, each cardiac chamber length, width and area, both ventricular wall thicknesses as well as the interventricular septal wall thickness. On the other hand, Aksoy C et al. [8] included only four fetal heart parameters in their study using the three-vessel view such as superior vena cava (SVC), Ao, PA diameters as well as the PA/Ao ratio. While Lussier EC et al. [14] used only thirteen fetal echocardiographic measurements within their study such as the whole heart longitudinal, transverse diameters and area, both chest and heart circumferences, pulmonary and Ao annulus diameters, all the four chambers transverse diameters in addition to transverse ductus arteriosus and transverse aortic isthmus diameters as well. Whereas, García-Otero L et al. [11] covered only eighteen fetal cardiac parameters such as the whole heart width, length and area, myocardial wall thicknesses and the width, length and area for each cardiac chamber too. The mean maternal age among our study subjects was 29.87 ± 5.66 years with a range between 20 and 39 years. Almost similar to the study carried out by Aksoy C et al. [8] where the mean maternal age was 29.2 ± 5.2 years. Additionally, Nadeem B et al. [15] stated that the maternal age in their study had a range between 20 and 37 years with a mean age of 27.3 ± 4.4 years. Also, the mean maternal age in a study carried out by García-Otero L et al. [11] was 32.5 ± 5.0 years. Apart from slight variances in the measurements as reported in the foregoing studies by García-Otero L et al. [11] , Lussier EC et al. [14] and Gu X et al. [16] our study showed that all the measured fetal cardiac parameters increase steadily with the progress of gestation. These slight variations in the measurements might be attributable to the study population demographic differences, different study techniques used or sample size disparities. In agreement with García-Otero L et al. [11] and Gabbay-Benziv R et al. [17] we found that both the left and right sides of heart are nearly equal in size at early weeks of gestation nevertheless with advance of pregnancy the right-side structures become slightly larger compared to the left side. Cardiac dimensions: As per the García-Otero L et al. [11] proposal to measure the cardiac transverse diameter beneath the atrioventricular valves being the most accurate representation of the mid-cardiac length with the maximal possible transverse diameter we in our study thoroughly went along with such approach as our numbers manifested. In the current study, the fetal cardiac transverse and longitudinal diameters as well as areas references are mostly consistent with prior published data showing a progressive increase with advance in gestational age with mean value of cardiac transverse diameter increased from 16.58 ± 0.38 mm at 20 th week of gestation to 40.34 ± 1.86 mm at 38 th week of gestation. While the mean value of cardiac longitudinal diameter increased from 20.85 ± 0.73 mm at 20 th week of gestation to 50.81 ± 1.40 mm at 38 th week of gestation and the mean value of cardiac area increased from 267.90 ± 15.53 mm 2 at 20 th week of gestation to 1639.54 ± 119.98 mm 2 at 38 th week of gestation showing clear correlation with the results established by Lussier EC et al. [14] , García-Otero L et al. [11] and Li X et al. [18] . Atrial dimensions: Our study results in the light of both atrial transverse and longitudinal dimensions besides the atrial areas are substantially in concurrence with previously published data by García-Otero L et al. [11] . In the current study, the estimated mean value of the left atrial transverse diameter increased from 6.53 ± 0.56 mm at 20 th week of gestation to 16.64 ± 1.10 mm at 38 th week of gestation while for the right atrial transverse diameter increased from 6.87 ± 0.58 mm at 20 th week of gestation to 16.67 ± 1.18 mm at 38 th week of gestation. Whereas the estimated mean value of the left atrial longitudinal diameter increased from 6.40 ± 0.61 mm at 20 th week of gestation to 16.83 ± 1.27 mm at 38 th week of gestation while for the right atrial longitudinal diameter increased from 6.32 ± 0.55 mm at 20 th week of gestation to 16.64 ± 1.15 mm at 38 th week of gestation. Furthermore, the mean value of the left atrial area increased from 38.79 ± 6.52 mm 2 at 20 th week of gestation to 224.13 ± 37.05 mm 2 at 38 th week of gestation while for the right atrial area increased from 38.91 ± 6.18 mm 2 at 20 th week of gestation to 228.34 ± 36.41 mm 2 at 38 th week of gestation. Ventricular dimensions: Our study results considering both ventricular transverse and longitudinal dimensions as well as the ventricular areas are mostly consistent with previously published data by García-Otero L et al. [11] . In the current study, the estimated mean value of the left ventricular transverse diameter increased from 5.77 ± 0.62 mm at 20 th week of gestation to 14.78 ± 1.52 mm at 38 th week of gestation while for the right ventricular transverse diameter increased from 5.85 ± 0.67 mm at 20 th week of gestation to 15.08 ± 1.30 mm at 38 th week of gestation. While the estimated mean value of the left ventricular longitudinal diameter increased from 12.10 ± 1.12 mm at 20 th week of gestation to 26.97 ± 2.63 mm at 38 th week of gestation while for the right ventricular longitudinal diameter increased from 10.62 ± 1.25 mm at 20 th week of gestation to 27.07 ± 2.40 mm at 38 th week of gestation. Moreover, the mean value of the left ventricular area increased from 65.71 ± 13.01 mm 2 at 20 th week of gestation to 357.52 ± 71.23 mm 2 at 38 th week of gestation while for the right ventricular area increased from 58.31 ± 12.32 mm 2 at 20 th week of gestation to 365.19 ± 63.28 mm 2 at 38 th week of gestation, similarly Gu X et al. [16] reported same results. Myocardial wall thicknesses: All our normal values of the right and left ventricular wall thicknesses as well as the interventricular septal wall thickness showed a progressive increase with advance in gestation. The current study results revealed that the mean left ventricular wall thickness value increased from 1.11 ± 0.13 mm at 20 th week of gestation to 3.80 ± 0.05 mm at 38 th week of gestation while for the right ventricular wall thickness increased from 1.08 ± 0.11 mm at 20 th week of gestation to 3.36 ± 0.07 mm at 38 th week of gestation and the mean value of the thickness of interventricular septal wall increased from 1.05 ± 0.09 mm at 20 th week of gestation to 3.45 ± 0.09 mm at 38 th week of gestation. In concurrence with the prior results established by García-Otero L et al. [19] , Daimei T et al. [20] as well as Rai P et al. [21] who concluded that both left and right ventricular wall thicknesses increased from 2 mm at 21 week of gestational age reaching 5 mm at the 40 th week of gestation. PA, aorta diameters and the PA/Ao ratio: In agreement with all prior studies, we observed that fetal pulmonary arterial diameter was always larger than aortic diameter. Moreover, both PA and aorta showed a progressively increased diameters throughout different gestational ages from 20 weeks till 38 weeks and were firmly correlated to the fetal age. Nevertheless, we found that the PA/Ao ratio was approximately constant across gestation. This agrees with Aksoy C et al. [8] who stated that the aorta and PA diameters increased with the advance of fetal gestational age between 20 and 24 weeks of gestation however the PA/Ao ratio remains constant. Also, Tayade AT et al. [22] stated that from 18 till 26 gestational ages in weeks the pulmonary arterial diameter enlarged with the progress of gestational age. In our study, the mean value of the fetal PA diameter increased from 3.20 ± 0.18 mm at 20 th week of gestation to 8.02 ± 0.11 mm at 38 th week of gestation while for the aorta diameter increased from 2.78 ± 0.15 mm at 20 th week of gestation to 6.77 ± 0.09 mm at 38 th week of gestation while the PA/Ao ratio ranged between 1.118 and 1.190 with a mean of 1.166 ± 0.012 and a mode of 1.155. This agrees with Aksoy C et al. [8] who stated that the mean diameter of aorta was 3.70 ± 0.54 mm, while the mean PA diameter was 4.28 ± 0.51 mm. Furthermore, the PA/Ao ratio was 1.17 ± 0.14 and the PA diameter was 12% larger than aorta diameter. Also, Nadeem B et al. [15] stated that the average PA diameter ranged from 2.35 ± 0.13 mm at 18 weeks of gestation to 3.60 ± 0.19 mm at 26 weeks of gestation while the average diameter of Ao ranged from 1.56 ± 0.45 mm at the 18 th week of gestation up to 1.60 ± 0.27 mm during the 26 th week of gestation. Additionally, Tayade AT et al. [22] stated that the mean PA diameter was 3.37 ± 0.66 mm with a diameter change from 2.48 ± 0.27 mm during the 18 th week of gestation till reaching 4.68 ± 0.37 mm at the 26 th week of gestation. Conclusion It could be concluded that utilization of simple, easy and time saving ultrasound screening planes such as the four-chamber and three-vessel views during routine antenatal ultrasonographic examinations can enhance and boost the prenatal detection rate of CHD which in turn will be reflected as better newborn outcomes. Our study has proposed reference ranges for twenty-one fetal normal cardiac parameters among the Egyptian population from the 20 th to the 38 th week of gestation which would facilitate detection of any deviation from normality as well as recognition of any undergoing cardiac morphology changes. Our recommendations are to employ such handy, fast and non-invasive ultrasound scans during routine prenatal examination visits to assess the fetal heart morphology, detect any deviation from normality and enhance the detection rate of CHD prenatally. Moreover, conducting further studies with a large sample size from different demographic segmentations to prove our results is essential and recommended to develop more the references. Abbreviations CHD: Congenital heart disease; GA: Gestational age; PA: Pulmonary artery; 3VV: Three-vessel view; Ao: Aorta; 4CV: Four-chamber view. Declarations Ethics approval and consent to participate Our current study was approved by the local ethical and scientific committee, faculty of Medicine, Menoufia university. All subjects were informed about the nature of the examination and signed consents were acquired. Consent for publication All authors gave consent to publish the manuscript. Funding None Author Contribution AAZ contributed to the conception of the study, design of the study, acquisition and analysis of the data, interpretation of data, creation of the final work, study revision, and accuracy or integrity of the submitted manuscript. AMH contributed to the conception of the study, design of the study, acquisition and analysis of the data, interpretation of data, creation of the final work, study revision, and accuracy or integrity of the submitted manuscript. BSS contributed to the conception of the study, design of the study, acquisition and analysis of the data, interpretation of data, creation of the final work, study revision, and accuracy or integrity of the submitted manuscript. All authors have read and approved the manuscript. Data Availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request References Van Nisselrooij AEL, Teunissen AKK, Clur SA, et al. (2020)Why are congenital heart defects being missed? Ultrasound Obstet Gynecol . 55(6):747-757. Ronai C, Freud LR, Brown DW, et al. (2020)Low prenatal detection rate of valvar pulmonary stenosis: What are we missing? Prenat Diagn . 40(8):966-971. Dudnikov O, Quinton A, Alphonse J. (2022)The detection rate of first trimester ultrasound in the diagnosis of congenital heart defects: A narrative review. Sonography . 8(2):36-42. Charafeddine F, Hachem A, Kibbi N, et al. (2019)The first fetal Echocardiography experience for Prenatal diagnosis of Congenital Heart Disease in Lebanon: Successes and challenges. J Saudi Heart Assoc . 31(3):125-129. Sriraam N, Prabha P. (2019)A Primitive Survey on Ultrasonic Imaging-Oriented Segmentation Techniques for Detection of Fetal Cardiac Chambers. Int J Biomed Clin Eng . 8(2):69-79. Tanaka T, Inamura N, Kawazu Y, et al. (2022)A rapid and Easy Objective Evaluation of the Three Vessel View to Enhance Diagnostic Confidence in Fetal Echocardiography. J Fetal Med . 9:1-5. Guirado L, Crispi F, Masoller N, et al. (2018)Biventricular impact of mild to moderate fetal pulmonary valve stenosis. Ultrasound Obstet Gynecol . 51(3):349-356. Aksoy C, Şimşek A, Özgür Ö, et al. (2023)The reference diameters of the three great vessels in the fetuses between 20-24 weeks by sonography. Akd Med J . 9(3):241-246. Carvalho JS, Axt-Fliedner R, Chaoui R, et al. (2023)ISUOG Practice Guidelines (updated): fetal cardiac screening. Ultrasound Obstet Gynecol . 61(6):788-803. Gudigar A, U R, Samanth J, et al. (2022)Role of Four-Chamber Heart Ultrasound Images in Automatic Assessment of Fetal Heart: A Systematic Understanding. Informatics . 9(2):34. García-Otero L, Gómez O, Rodriguez-López M, et al. (2020)Nomograms of Fetal Cardiac Dimensions at 18-41 Weeks of Gestation. Fetal Diagn Ther . 47(5):387-398. Picazo-Angelin B, Zabala-Argüelles JI, Anderson RH, et al. (2018)Anatomy of the normal fetal heart: The basis for understanding fetal echocardiography. 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Li X, Zhou Q, Huang H, et al. (2015)Z-score reference ranges for normal fetal heart sizes throughout pregnancy derived from fetal echocardiography. Prenat Diagn . 35(2):117-124. García-Otero L, Soveral I, Sepúlveda-Martínez Á, et al. (2021)Reference ranges for fetal cardiac, ventricular and atrial relative size, sphericity, ventricular dominance, wall asymmetry and relative wall thickness from 18 to 41 gestational weeks. Ultrasound Obstet Gynecol . 58(3):388-397. Daimei T, Damayanti N, Sinam V. (2014)Difference between the left and right ventricular thickness in fetal heart. IOSR J Dent Med Sci . 13(4):21-24. Rai P, Bhushan R, Singh R. (2018)Assessment of Fetal Left and Right Ventricular Thickness and Its Comparison with Other Parameters: A Study of 20 Cases. J Med Sci Health 4(3):7-12. Tayade AT, Singh N, Kale SK, et al. (2017)Nomogram of Fetal Pulmonary Artery Diameter in Second Trimester of Pregnancy. Int J Sci Stud . 4(12):41-45. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 03 Dec, 2025 Read the published version in Egyptian Journal of Radiology and Nuclear Medicine → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7068652","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":529242005,"identity":"dc14c9a3-680a-4267-9cb4-9e62c35d9f58","order_by":0,"name":"Ashraf Anas Zytoon","email":"","orcid":"","institution":"Menoufia University","correspondingAuthor":false,"prefix":"","firstName":"Ashraf","middleName":"Anas","lastName":"Zytoon","suffix":""},{"id":529242006,"identity":"1f085757-b7cd-4cbe-bd12-64cb74631629","order_by":1,"name":"Amr Mostafa 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1","display":"","copyAsset":false,"role":"figure","size":284790,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section of the fetal thorax at 29 weeks of gestation just above the diaphragm at the four-chamber view level showing normal location of the heart on the left side of the thoracic cavity with the apex pointing to the left side (levocardia). The most posterior chamber is the left atrium just anterior to the spine and descending aorta while the most anterior chamber is the right ventricle behind the sternum.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations: DAo, descending aorta; LV, left ventricle; LA, left atrium; RV, right ventricle; RA, right atrium; Sp, spine.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/0e60d62b44799109acf98090.png"},{"id":93611003,"identity":"8a3edf30-1909-42b1-880d-b8eaeb866ddc","added_by":"auto","created_at":"2025-10-15 16:12:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1077173,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the four-chamber view level during end-diastole with closed atrioventricular valves, (\u003cstrong\u003ea\u003c/strong\u003e) of a fetus at 28 weeks of gestation while (\u003cstrong\u003eb\u003c/strong\u003e) of a fetus at 30 weeks of gestation, both showing fully dilated ventricles.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/c1284126eff2ccf8388fba3f.png"},{"id":93611002,"identity":"b31805e3-e39c-4c6c-9f02-aaaa90fe8f7e","added_by":"auto","created_at":"2025-10-15 16:12:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":847141,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the four-chamber view level during end-systole prior to opening of the atrioventricular valves, (\u003cstrong\u003ea\u003c/strong\u003e) of a fetus at 29 weeks of gestation while (\u003cstrong\u003eb\u003c/strong\u003e) of a fetus at 30 weeks of gestation, both showing fully distended atria.\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/ba3d6828264a503afd0a0668.png"},{"id":93612477,"identity":"d29e6897-69bc-40ad-b3e2-f79c85a01ccf","added_by":"auto","created_at":"2025-10-15 16:20:03","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":441908,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the four-chamber view level during end-diastole showing the method of obtaining the cardiac dimensions with cardiac transverse diameter measured just below the atrioventricular valves while its longitudinal diameter marked by the line equally dividing the interventricular septum, also cardiac area was measured by manual tracing along the inner myocardium.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations: LV, left ventricle; LA, left atrium; RV, right ventricle; RA, right atrium.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/7ba3509651bd27a856b90651.png"},{"id":93611005,"identity":"e63ae3ba-4929-4487-9d9e-eacea1eb4353","added_by":"auto","created_at":"2025-10-15 16:12:03","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":421417,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the four-chamber view level during end-systole showing the method of obtaining both atrial longitudinal and transverse diameters by the lines dividing the atria into four equivalent squares while atrial areas were measured by manual tracing along the inner myocardium.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations: LA, left atrium; RA, right atrium.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure5.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/e4427b2b877d33fe64ecc96d.png"},{"id":93613456,"identity":"bbdbde11-ab3d-4b8a-bf7b-5291541af8c6","added_by":"auto","created_at":"2025-10-15 16:28:03","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":413820,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the four-chamber view level during end-diastole showing the method of obtaining both ventricular transverse diameters below the atrioventricular valves and their longitudinal diameters from the atrioventricular valves level till each ventricular apex while their areas were acquired by manual tracing along the inner myocardium including the endocardium, the moderator band and the muscular trabeculations inside the ventricular cavity.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations: LV, left ventricle; RV, right ventricle.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure6.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/570ca219233dd94776814f53.png"},{"id":93611010,"identity":"8b88e66f-e224-4302-b5fa-70041278ea42","added_by":"auto","created_at":"2025-10-15 16:12:03","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":444549,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the four-chamber view level during end-diastole showing the method of obtaining both ventricular and interventricular septal wall thicknesses.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations: LV, left ventricle; RV, right ventricle.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure7.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/492e9de43a5fe99777acf5a8.png"},{"id":93611012,"identity":"bcf08a9e-d152-433d-8e26-6f258d1cab3f","added_by":"auto","created_at":"2025-10-15 16:12:03","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":534016,"visible":true,"origin":"","legend":"\u003cp\u003eUltrasound transverse cut section at the three-vessel view level of a fetus at 29 weeks of gestation showing the pulmonary artery, aorta and superior vena cava arranged in a straight line and in decreasing order in size from left-anterior to right-posterior in mediastinum, respectively. Both PA and Ao diameters were measured by placing the calipers on the lines that define the vessel wall.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations: PA, pulmonary artery; SVC, superior vena cava; Ao, aorta.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure8.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/fbca0766f28ba1da6e4f75d2.png"},{"id":93613457,"identity":"e6265788-e994-48c8-81b0-b2b2c106cafa","added_by":"auto","created_at":"2025-10-15 16:28:03","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":101857,"visible":true,"origin":"","legend":"\u003cp\u003eBar chart for gestational age frequency distribution among participants.\u003c/p\u003e","description":"","filename":"Figure9.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/25ec7644ce4880101eb2a02e.png"},{"id":93612482,"identity":"d444f7de-cab0-4ad7-bd6c-8914fc36aca4","added_by":"auto","created_at":"2025-10-15 16:20:04","extension":"png","order_by":10,"title":"Figure 10","display":"","copyAsset":false,"role":"figure","size":611749,"visible":true,"origin":"","legend":"\u003cp\u003eScatter diagram of gestational age and estimated references for the fetal pulmonary artery (\u003cstrong\u003ea\u003c/strong\u003e) and aorta (\u003cstrong\u003eb\u003c/strong\u003e) diameters in addition to the PA/Ao ratio (\u003cstrong\u003ec\u003c/strong\u003e) among studied normal pregnancies.\u003c/p\u003e","description":"","filename":"Figure10.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/14c0a1c3eb14aa7e1251f4e7.png"},{"id":93613460,"identity":"d47eb2f7-325d-478a-92f9-e6dc100910b1","added_by":"auto","created_at":"2025-10-15 16:28:04","extension":"png","order_by":11,"title":"Figure 11","display":"","copyAsset":false,"role":"figure","size":957360,"visible":true,"origin":"","legend":"\u003cp\u003eScatter diagram of gestational age and estimated references for the fetal cardiac transverse (\u003cstrong\u003ea\u003c/strong\u003e) and longitudinal (\u003cstrong\u003eb\u003c/strong\u003e) diameters in addition to the cardiac area (\u003cstrong\u003ec\u003c/strong\u003e) among studied normal pregnancies.\u003c/p\u003e","description":"","filename":"Figure11.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/4cbfbd8a058ff1d39e4a23f5.png"},{"id":93612485,"identity":"65bf356a-382c-4daa-ac0b-8bb6e1d4eb19","added_by":"auto","created_at":"2025-10-15 16:20:04","extension":"png","order_by":12,"title":"Figure 12","display":"","copyAsset":false,"role":"figure","size":1905888,"visible":true,"origin":"","legend":"\u003cp\u003eScatter diagram of gestational age and estimated references for the fetal left atrial transverse (\u003cstrong\u003ea\u003c/strong\u003e) and longitudinal (\u003cstrong\u003eb\u003c/strong\u003e) diameters and the left atrial area (\u003cstrong\u003ec\u003c/strong\u003e) besides the fetal right atrial transverse (\u003cstrong\u003ed\u003c/strong\u003e) and longitudinal (\u003cstrong\u003ee\u003c/strong\u003e) diameters in addition to the right atrial area (\u003cstrong\u003ef\u003c/strong\u003e) among studied normal pregnancies.\u003c/p\u003e","description":"","filename":"Figure12.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/dc8aeb2b8817cb1f8eaa5bfc.png"},{"id":93613459,"identity":"64ad91ed-1117-4df5-a754-469f2dd8445f","added_by":"auto","created_at":"2025-10-15 16:28:04","extension":"png","order_by":13,"title":"Figure 13","display":"","copyAsset":false,"role":"figure","size":1983413,"visible":true,"origin":"","legend":"\u003cp\u003eScatter diagram of gestational age and estimated references for the fetal left ventricular transverse (\u003cstrong\u003ea\u003c/strong\u003e) and longitudinal (\u003cstrong\u003eb\u003c/strong\u003e) diameters and the left ventricular area (\u003cstrong\u003ec\u003c/strong\u003e) besides the fetal right ventricular transverse (\u003cstrong\u003ed\u003c/strong\u003e) and longitudinal (\u003cstrong\u003ee\u003c/strong\u003e) diameters in addition to the right ventricular area (\u003cstrong\u003ef\u003c/strong\u003e) among studied normal pregnancies.\u003c/p\u003e","description":"","filename":"Figure13.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/d21c3c4150c7660a4af81f74.png"},{"id":93612487,"identity":"796f5700-8e0b-4be2-8d5a-3250902e3be5","added_by":"auto","created_at":"2025-10-15 16:20:04","extension":"png","order_by":14,"title":"Figure 14","display":"","copyAsset":false,"role":"figure","size":707665,"visible":true,"origin":"","legend":"\u003cp\u003eScatter diagram of gestational age and estimated references for the fetal left ventricular (\u003cstrong\u003ea\u003c/strong\u003e), right ventricular (\u003cstrong\u003eb\u003c/strong\u003e) and interventricular septal (\u003cstrong\u003ec\u003c/strong\u003e) wall thicknesses among studied normal pregnancies.\u003c/p\u003e","description":"","filename":"Figure14.png","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/e3db2875b15a7c8a2ac05112.png"},{"id":97723887,"identity":"97130b98-30e6-4015-a317-59491ca6e50f","added_by":"auto","created_at":"2025-12-08 16:09:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":12222111,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7068652/v1/d6590547-6171-4dcb-a2f8-28116495208f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Normal fetal cardiac morphometric parameters reference across gestation","fulltext":[{"header":"Background","content":"\u003cp\u003eCongenital heart disease (CHD) is a serious life-threatening medical condition in newborns with high mortality and leads to about fifty percent of the entire newborn deaths from congenital anomalies \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHowever fetal magnetic resonance imaging has the upper hand for different organs imagining with no risk of exposure to radiation, it\u0026rsquo;s of a low importance when it comes to cardiac imaging because of its sensitivity to motion. Hence, different imaging procedure such as ultrasound using the three-vessel and four-chamber views is a better option to evaluate and detect any cardiac chambers and outflow abnormalities \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eSince early detected CHD cases have demonstrated higher survival rate through early recognition of the anomaly prenatally and saving time for early intervention through the possible surgical options postnatally to save lives. Enhancing CHD detection rates is a priority \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eRegarding the knowledge that any abnormality of the fetal heart anatomy is compensated through remodeling pathway to overcome the flow disturbance inside the chambers as well as the main outflow vessels, and the ease and time saving ultrasound sections such as the three-vessel and four-chamber views. Any cardiac anomaly will be early manifested by deviation from the normal ranges of the cardiac measurements \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe goal of the present study was to construct those reference ranges for the fetal normal heart at different gestational ages to help detect any deviation from normality. The three-vessel view was obtained to measure the fetal PA and Ao diameters then the PA/Ao ratio was calculated. Furthermore, the four-chamber view was used to measure the remaining fetal cardiac dimensions. Finally, the measurements values for each gestational age in weeks were gathered and analyzed to establish the normal ranges of each parameter including the upper and lower bounds for every gestational age.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFive hundred pregnant women with singleton pregnancies referred to our radiology department during the period time from January 2024 to January 2025 for their routine ultrasound examination were included in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll subjects included were informed and became familiar of the examination and its nature then voluntary applied for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study final statistical analysis only included the subjects with normal fetal morphology and anomaly scan results as well as accurate pregnancy dating through the last menstruation period and ultrasonographic measurements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were considered as follows: multiple pregnancies, fetal malformations, maternal hypertension, family history of congenital abnormalities, diabetes mellitus, pre-eclampsia, amniotic fluid index abnormalities as well as mismatching between gestational age calculated by the last menstruation period and obstetric ultrasound measurements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEquipment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUltrasonography images were acquired with real time ultrasound equipment at our department (LOGIQ P7 GE Healthcare Sonography Machine from General Electric Healthcare Technologies, Inc. Chicago, Illinois, United States) equipped with 2-5 MHz curvilinear transducer.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUltrasound image acquisition and orientation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAt first a routine obstetric ultrasound scan was performed and the fetal situs was defined. Afterwards, the four-chamber view \u003cstrong\u003e(Fig. 1)\u003c/strong\u003e was obtained through a transverse cut section across the fetal thorax just above the diaphragm, a true transverse cut section is confirmed with inspection of at least one rib on each side of the fetal chest wall.\u0026nbsp;Subsequently, the entire heart, both ventricular dimensions as well as both ventricular and interventricular wall thicknesses were measured at their maximal size during end-diastole \u003cstrong\u003e(Fig. 2)\u003c/strong\u003e confirmed by fully dilatation of the ventricles during closure of the atrioventricular valves. While the atrial dimensions were obtained at their maximal size during end-systole \u003cstrong\u003e(Fig. 3)\u003c/strong\u003e confirmed by the frame prior to opening of the atrioventricular valves.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e(Figure 1)\u003c/p\u003e\n\u003cp\u003e(Figure 2)\u003c/p\u003e\n\u003cp\u003e(Figure 3)\u003c/p\u003e\n\u003cp\u003eCardiac transverse diameter was measured below the atrioventricular valves while its longitudinal diameter was measured from base till apex of the heart during end-diastole \u003cstrong\u003e(Fig. 4)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e(Figure 4)\u003c/p\u003e\n\u003cp\u003eBoth atrial transverse and longitudinal diameters were measured by the lines dividing the atria into four equivalent squares additionally their areas were measured too during end-systole \u003cstrong\u003e(Fig. 5)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e(Figure 5)\u003c/p\u003e\n\u003cp\u003eBoth ventricular transverse diameters were measured below the atrioventricular valves while their longitudinal diameters were measured from the atrioventricular valves level till ventricular apex likewise their areas were measured also during end-diastole \u003cstrong\u003e(Fig. 6)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e(Figure 6)\u003c/p\u003e\n\u003cp\u003eBoth ventricular wall as well as the interventricular septal wall thicknesses were measured during end-diastole \u003cstrong\u003e(Fig. 7)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e(Figure 7)\u003c/p\u003e\n\u003cp\u003eSubsequently, the three-vessel view was obtained by sliding the transducer cranially while maintaining a transverse section of the fetal thorax. \u0026nbsp;The PA, Ao as well as superior vena cava (SVC) are arranged in a straight line from left-anterior to right-posterior in mediastinum, respectively. The PA is the largest in size while the SVC is the smallest. Both PA and Ao diameters were measured by placing the calipers on the lines that define the vessel wall then the PA/Ao ratio was computed \u003cstrong\u003e(Fig. 8)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e(Figure 8)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults were collected, tabulated and statistically analyzed using IBM SPSS Statistics package program version 30.0 for Windows (IBM, Armonk, NY).\u003c/p\u003e\n\u003cp\u003eDescriptive statistics methods were carried out in the form of graphical as well as numerical description techniques as follow: quantitative data were demonstrated in the form of mean ( ) \u0026plusmn; standard deviation (SD) and range whereas qualitative data were represented as frequencies and relative frequencies. For graphical descriptive techniques we used bar chart as well as scatter diagram.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eInitially, 514 pregnancies were qualified for our study, 14 of them were excluded due to discordance in measurements (outliers). Eventually, a total of 500 subjects with normal singleton pregnancies of gestational age between 20 and 38 weeks (mean maternal age, 29.87; SD, 5.66) were included for the references construction as shown in \u003cstrong\u003eTable 1\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIncluded subjects in the study had a gestational age ranged between 20 and 38 weeks, the mean estimated gestational age was 27.44 weeks with a standard deviation of \u0026plusmn; 5.33 as detailed in \u003cstrong\u003eTable 2\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost of cases 9.6% were in 22\u003csup\u003end\u003c/sup\u003e week of gestation, 9% in 21\u003csup\u003est\u003c/sup\u003e week, 8.4% in 25\u003csup\u003eth\u003c/sup\u003e week, 7.6% in 24\u003csup\u003eth\u003c/sup\u003e week, 6.8% in 36\u003csup\u003eth\u003c/sup\u003e week, 6.6% in 28\u003csup\u003eth\u003c/sup\u003e week, 6.4% in 34\u003csup\u003eth\u003c/sup\u003e week, 6.2% in 30\u003csup\u003eth\u003c/sup\u003e week, 5.8% in 20\u003csup\u003eth\u003c/sup\u003e and 23\u003csup\u003erd\u003c/sup\u003e week, 5.6% in 29\u003csup\u003eth\u003c/sup\u003e week, 4.4% in 35\u003csup\u003eth\u003c/sup\u003e week, 3.8% in 27\u003csup\u003eth\u003c/sup\u003e week, 3% in 33\u003csup\u003erd\u003c/sup\u003e week, 2.8% in 26\u003csup\u003eth\u003c/sup\u003e week, 2.6% in 32\u003csup\u003end\u003c/sup\u003e week, 2.2% in 31\u003csup\u003est\u003c/sup\u003e and 37\u003csup\u003eth\u003c/sup\u003e week, and 1.2% in 38\u003csup\u003eth\u003c/sup\u003e week of gestation as illustrated in \u003cstrong\u003eFig. 9\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e(Figure 9)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eScatter diagrams presented by each gestational age in weeks for the evaluated twenty-one fetal cardiac parameters such as PA diameter, Ao diameter, PA/Ao ratio, transverse and longitudinal diameters as well as area for the heart and for each chamber separately in addition to both ventricular and interventricular septal wall thicknesses also are shown in \u003cstrong\u003eFig. 10-14\u003c/strong\u003e and \u003cstrong\u003eTables 3-6\u003c/strong\u003e respectively.\u003c/p\u003e\n\u003cp\u003e(Figure 10)\u003c/p\u003e\n\u003cp\u003e(Figure 11)\u003c/p\u003e\n\u003cp\u003e(Figure 12)\u003c/p\u003e\n\u003cp\u003e(Figure 13)\u003c/p\u003e\n\u003cp\u003e(Figure 14)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e Demographic distribution of the participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMaternal age descriptive statistics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eValue\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMean (\u003c/span\u003e\u003c/strong\u003e x̄)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29.87\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eStandard deviation (SD)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cspan\u003e\u0026plusmn; 5.66\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMinimal estimated maternal age\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20 years\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMaximal estimated maternal age\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cspan\u003e39 years\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e Gestational age distribution\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eGestational age (GA) descriptive statistics\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 305px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eValue\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMean (\u003c/span\u003e\u003c/strong\u003e x̄)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 305px;\"\u003e\n \u003cp\u003e\u003cspan\u003e27.44\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eStandard deviation (SD)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 305px;\"\u003e\n \u003cp\u003e\u003cspan\u003e\u0026plusmn; 5.33\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMinimal estimated\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan\u003e gestational age\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 305px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20 weeks\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan\u003eMaximal\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan\u003e estimated\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan\u003e gestational age\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 305px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38 weeks\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e Reference ranges for the fetal pulmonary artery and aorta diameters along with the PA/Ao ratio\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003eGA (weeks)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003eNo. of subjects\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003ePA diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003eAo diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003ePA/Ao ratio\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.20 (2.91 - 3.50)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.78 (2.54 - 3.03)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.151 (1.141 - 1.166)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e21W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e45\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.49 (3.32 - 3.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.03 (2.91 - 3.19)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.153 (1.141 - 1.160)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e48\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.82 (3.58 - 4.06)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.30 (3.09 - 3.52)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.157 (1.118 - 1.167)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e23W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.07 (3.91 - 4.18)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.51 (3.38 - 3.62)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.158 (1.153 - 1.172)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e24W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.29 (4.10 - 4.46)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.71 (3.54 - 3.89)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.156 (1.140 - 1.167)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e42\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.54 (4.32 - 4.78)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.91 (3.78 - 4.05)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.160 (1.134 - 1.180)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.81 (4.62 - 4.98)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.15 (3.98 - 4.31)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.159 (1.153 - 1.167)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e27W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e19\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.13 (4.95 - 5.29)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.37 (4.26 - 4.47)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.173 (1.162 - 1.183)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e28W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e33\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.41 (5.24 - 5.59)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.61 (4.43 - 4.77)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.176 (1.163 - 1.183)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e28\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.65 (5.44 - 5.86)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e4.82 (4.65 - 4.96)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.174 (1.165 - 1.186)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e30W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e31\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.90 (5.72 - 6.13)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.02 (4.86 - 5.19)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.175 (1.153 - 1.184)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e31W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.21 (6.05 - 6.39)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.28 (5.18 - 5.37)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.176 (1.168 - 1.190)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e32W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e13\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.49 (6.34 - 6.65)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.53 (5.37 - 5.67)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.174 (1.165 - 1.181)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e33W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.76 (6.60 - 6.92)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.73 (5.63 - 5.84)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.178 (1.172 - 1.185)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e34W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e32\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.97 (6.86 - 7.09)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.91 (5.80 - 6.02)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.180 (1.176 - 1.184)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e35W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.24 (7.05 - 7.41)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.19 (6.06 - 6.33)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.169 (1.162 - 1.178)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e36W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e34\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.57 (7.41 - 7.75)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.44 (6.30 - 6.58)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.176 (1.166 - 1.180)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e37W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.83 (7.66 - 7.98)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.91 (6.49 - 6.72)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.184 (1.180 - 1.190)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.02 (7.87 - 8.15)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.77 (6.64 - 6.87)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.184 (1.180 - 1.186)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e Reference ranges for fetal cardiac transverse and longitudinal dimensions as well as the cardiac area along with ventricular and interventricular septal wall thicknesses\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003eGA (weeks)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003eNo. of subjects\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003eCardiac transverse diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003eCardiac longitudinal diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003eCardiac area (mm\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft ventricular wall thickness (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight ventricular wall thickness (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003eSeptal wall thickness (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.58 (15.88 - 17.27)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20.85 (19.77 - 21.93)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e267.9 (243.17 - 293.35)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.11 (0.90 - 1.30)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.08 (0.90 - 1.26)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.05 (0.89 - 1.19)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e21W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e45\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e18.14 (16.93 - 19.35)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22.46 (20.98 - 23.94)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e316.41 (275.41 - 359.17)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.40 (1.27 - 1.53)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.32 (1.23 - 1.42)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.23 (1.14 - 1.32)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e48\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e19.92 (18.51 - 21.36)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e23.37 (21.11 - 25.66)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e372.12 (312.45 - 436.85)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.53 (1.38 - 1.67)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.46 (1.32 - 1.57)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.37 (1.27 - 1.46)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e23W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e21.03 (19.18 - 22.89)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25.77 (24.08 - 27.46)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e452.52 (384.79 - 523.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.70 (1.61 - 1.80)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.59 (1.51 - 1.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.49 (1.41 - 1.58)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e24W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22.68 (20.73 - 24.59)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26.97 (25.14 - 28.89)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e498.15 (424.04 - 578.01)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.84 (1.75 - 1.94)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.71 (1.64 - 1.79)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.62 (1.53 - 1.72)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e42\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e23.43 (21.85 - 25.13)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29.40 (27.93 - 30.92)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e575.04 (508.74 - 647.75)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.97 (1.88 - 2.07)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.82 (1.75 - 1.88)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.75 (1.66 - 1.96)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e24.95 (22.97 - 26.92)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e30.97 (29.10 - 32.83)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e645.11 (557.22 - 736.75)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.14 (2.04 - 2.22)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.94 (1.85 - 2.01)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1.88 (1.80 - 1.95)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e27W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e19\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26.15 (23.77 - 28.52)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e31.92 (29.95 - 33.89)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e697.15 (593.47 - 805.74)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.27 (2.16 - 2.38)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.07 (1.98 - 2.15)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.02 (1.92 - 2.11)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n 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54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e32\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e35.98 (32.82 - 38.96)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e44.45 (39.64 - 49.27)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1284.66 (1041.46 - 1536.64)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.27 (3.17 - 3.36)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.88 (2.80 - 2.96)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.92 (2.83 - 2.99)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e35W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e37.08 (34.66 - 39.43)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e46.98 (43.23 - 50.48)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1392.53 (1195.66 - 1588.33)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.42 (3.32 - 3.51)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e2.98 (2.91 - 3.05)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.07 (3.01 - 3.12)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e36W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e34\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38.71 (36.26 - 41.16)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e48.91 (45.44 - 52.04)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1519.12 (1316.59 - 1689.88)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.55 (3.46 - 3.63)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.09 (3.00 - 3.25)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.16 (3.07 - 3.25)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e37W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e39.08 (36.59 - 41.56)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e49.61 (46.82 - 52.12)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1551.19 (1368.93 - 1730.88)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.69 (3.59 - 3.78)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.22 (3.13 - 3.29)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.29 (3.19 - 3.37)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cspan\u003e40.34 (37.86 - 42.82)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e50.81 (48.87 - 52.47)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cspan\u003e1639.54 (1478.46 - 1795.33)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.80 (3.73 - 3.87)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.36 (3.27 - 3.48)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cspan\u003e3.45 (3.33 - 3.56)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e Reference ranges for fetal both atrial transverse and longitudinal dimensions along with the atrial areas\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003eGA (weeks)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003eNo. of subjects\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft atrial transverse diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft atrial longitudinal diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft atrial area (mm\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight atrial transverse diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight atrial longitudinal diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight atrial area (mm\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.53 (5.62 - 7.37)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.40 (5.50 - 7.39)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38.79 (28.32 - 48.69)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.87 (5.97 - 7.78)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.32 (5.49 - 7.23)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38.91 (29.45 - 48.11)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e21W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e45\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.12 (6.21 - 7.98)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.07 (6.02 - 8.13)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e49.19 (37.05 - 61.36)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.63 (6.54 - 8.72)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.05 (5.90 - 8.22)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e49.80 (37.42 - 62.47)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e48\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.8 (7.15 - 8.74)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.08 (6.75 - 9.98)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e60.06 (46.81 - 72.98)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.36 (7.35 - 9.35)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.88 (6.48 - 9.22)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e60.85 (46.21 - 73.70)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e23W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.32 (7.37 - 9.16)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.29 (7.40 - 9.30)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e68.32 (54.65 - 82.59)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.73 (7.56 - 9.69)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.37 (7.07 - 9.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e69.30 (56.93 - 83.79)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e24W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.75 (7.66 - 9.72)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.65 (7.11 - 10.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e79.24 (62.45 - 97.57)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.00 (8.03 - 10.01)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.74 (7.18 - 10.31)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e80.96 (63.57 - 99.25)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e42\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.23 (8.12 - 10.32)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.53 (8.27 - 10.69)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e87.31 (62.73 - 112.97)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.90 (8.16 - 11.58)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.49 (8.34 - 10.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e88.62 (63.68 - 114.69)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.87 (8.72 - 11.12)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.04 (8.75 - 11.33)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e100.95 (76.27 - 125.62)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.45 (8.68 - 12.21)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.32 (8.76 - 11.88)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e102.53 (77.97 - 127.09)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e27W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e19\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.55 (9.15 - 11.94)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.55 (9.18 - 11.89)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e111.3 (86.32 - 136.27)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.2 (10.13 - 12.27)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.94 (9.39 - 12.48)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e113.45 (87.67 - 140.48)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e28W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n 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39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e28\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.39 (10.11 - 12.73)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.77 (10.14 - 13.26)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e131.13 (101.93 - 162.87)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.95 (10.65 - 13.31)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.75 (10.17 - 13.26)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n 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42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.09 (12.01 - 16.35)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.33 (12.28 - 16.33)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e193.46 (148.75 - 239.46)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.45 (12.59 - 16.40)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.71 (12.78 - 16.66)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e197.90 (152.62 - 244.64)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e36W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e34\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.95 (13.52 - 16.29)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.79 (13.45 - 17.93)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e206.17 (158.47 - 250.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.11 (13.32 - 16.83)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.66 (13.82 - 17.36)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e210.12 (160.91 - 256.01)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e37W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.31 (14.86 - 17.84)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.46 (14.75 - 18.17)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e211.52 (169.85 - 243.68)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.06 (14.30 - 17.83)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.29 (14.84 - 17.73)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e214.18 (169.34 - 246.40)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.64 (15.17 - 18.11)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.83 (15.13 - 18.53)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cspan\u003e224.13 (173.79 - 270.40)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.67 (15.09 - 18.24)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.64 (15.10 - 18.17)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cspan\u003e228.34 (178.64 - 272.79)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6\u003c/strong\u003e Reference ranges for fetal both ventricular transverse and longitudinal dimensions along with the ventricular areas\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003eGA (weeks)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003eNo. of subjects\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft ventricular transverse diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft ventricular longitudinal diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003eLeft ventricular area (mm\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight ventricular transverse diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight ventricular longitudinal diameter (mm)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003eRight ventricular area (mm\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eMean (Range)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.77 (4.81 - 6.73)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e12.10 (10.33 - 13.76)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e65.71 (46.31 - 86.31)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e5.85 (4.66 - 6.77)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e10.62 (8.71 - 12.51)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e58.31 (37.83 - 78.93)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e21W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e45\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.53 (5.49 - 7.49)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e13.22 (11.35 - 14.98)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e83.36 (60.38 - 107.55)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6.43 (5.38 - 7.48)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.97 (10.32 - 13.44)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e77.17 (55.28 - 100.1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e22W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e48\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.16 (6.05 - 8.35)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.34 (12.59 - 15.96)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e100.85 (74.51 - 130.37)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.41 (6.06 - 8.92)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e13.12 (10.58 - 15.83)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e96.12 (62.72 - 138.13)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e23W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e29\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.75 (6.63 - 8.87)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.35 (13.14 - 17.56)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e116.30 (84.46 - 151.04)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e7.79 (6.66 - 8.92)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.64 (13.07 - 16.21)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e110.72 (84.41 - 140.27)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e24W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.30 (7.06 - 9.57)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.67 (12.95 - 18.63)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e111.99 (77.89 - 151.97)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.38 (7.21 - 9.64)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.60 (12.49 - 16.88)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e109.09 (79.72 - 144.15)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e42\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.90 (7.72 - 10.15)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e16.21 (12.89 - 19.15)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e128.95 (88.03 - 171.91)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e8.99 (7.25 - 10.32)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.33 (12.95 - 17.62)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e128.56 (92.87 - 168.44)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e9.53 (8.44 - 10.75)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e18.20 (16.08 - 20.30)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n 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42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e28\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.00 (9.54 - 12.42)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20.38 (17.32 - 23.22)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e206.39 (151.10 - 263.71)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.22 (9.66 - 12.60)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e19.86 (17.21 - 22.57)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e198.44 (147.17 - 251.71)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e30W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e31\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.61 (9.78 - 13.46)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e21.56 (18.64 - 24.37)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e230.78 (166.58 - 299.7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11.75 (10.11 - 13.40)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e20.76 (18.11 - 23.16)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n 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\u003cp\u003e\u003cspan\u003e13.50 (11.94 - 15.05)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25.05 (21.89 - 28.22)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e312.21 (240.14 - 390.08)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e13.64 (11.86 - 15.64)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e24.35 (21.38 - 27.38)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e310.98 (236.03 - 398.61)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e36W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e34\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.52 (12.48 - 16.47)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25.85 (22.29 - 28.87)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e328.63 (241.85 - 413.39)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.81 (12.87 - 16.62)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25.78 (22.35 - 28.82)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e333.15 (250.11 - 416.44)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e37W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.66 (12.66 - 16.63)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26.31 (22.91 - 29.23)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e345.61 (257.96 - 432.34)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.97 (13.28 - 16.58)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e25.92 (22.67 - 29.30)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e347.15 (267.76 - 432.07)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cspan\u003e38W\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cspan\u003e6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e14.78 (12.82 - 16.80)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cspan\u003e26.97 (23.46 - 30.41)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cspan\u003e357.52 (267.50 - 454.39)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cspan\u003e15.08 (13.29 - 16.66)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cspan\u003e27.07 (23.85 - 30.28)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cspan\u003e365.19 (281.91 - 448.67)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCongenital heart disease (CHD) is considered the most prevalent congenital anomaly among newborns. It is a serious life-threatening medical condition in newborns with high mortality rates\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ein nearly twenty-five percent of the affected babies\u003cstrong\u003e\u003csup\u003e\u0026nbsp;[9]\u003c/sup\u003e\u003c/strong\u003e. \u0026nbsp;In respect of the necessity for urgent postnatal medical and surgical interventions for some cases, early detection of CHD before birth will give a significant chance of timely treatment for better outcomes and higher survival rates\u0026nbsp;\u003cstrong\u003e\u003csup\u003e[10]\u003c/sup\u003e\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eRegarding the knowledge that any abnormality of the fetal heart anatomy is compensated through remodeling pathway to adapt and overcome the disturbance inside the chambers as well as the main outflow vessels. Any CHD will be associated with abnormal changes in the size and structure of the heart\u0026nbsp;\u003cstrong\u003e\u003csup\u003e[11, 12]\u003c/sup\u003e\u003c/strong\u003e. With the help of the ultrasound during routine antenatal scans, our current study provides standard references for fetal normal cardiac morphometric parameters during various gestational ages. Any deviation of these measurements should raise the possibility of an underlying congenital cardiac anomaly. Which will enhance the sensitivity of antenatal diagnosis of CHD\u0026nbsp;\u003cstrong\u003e\u003csup\u003e[13]\u003c/sup\u003e\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eThis study was carried on five hundred normal singleton pregnancies from the 20\u003csup\u003eth\u003c/sup\u003e to the 38\u003csup\u003eth\u003c/sup\u003e week of gestation (mean GA, 27.44; SD, 5.33).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the present study, our references involved twenty-one fetal cardiac parameters including diameters of both the\u0026nbsp;great vessels of the heart arising from the ventricles, the PA/Ao ratio, the whole heart length, width and area, each cardiac chamber length, width and area, both ventricular wall thicknesses as well as the interventricular septal wall thickness.\u0026nbsp;On the other hand,\u003cstrong\u003e\u0026nbsp;Aksoy C \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[8]\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003eincluded only four fetal heart parameters in their study using the three-vessel view such as superior vena cava (SVC), Ao, PA diameters as well as the PA/Ao ratio.\u003c/p\u003e\n\u003cp\u003eWhile \u003cstrong\u003eLussier EC \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[14]\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003eused only thirteen fetal echocardiographic measurements within their study such as the whole heart longitudinal, transverse diameters and area, both chest and heart circumferences, pulmonary and Ao annulus diameters, all the four chambers transverse diameters in addition to transverse ductus arteriosus and transverse aortic isthmus diameters as well.\u003c/p\u003e\n\u003cp\u003eWhereas, \u003cstrong\u003eGarc\u0026iacute;a-Otero L \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e covered only eighteen fetal cardiac parameters such as the whole heart width, length and area, myocardial wall thicknesses and the width, length and area for each cardiac chamber too.\u003c/p\u003e\n\u003cp\u003eThe mean maternal age among our study subjects was 29.87 \u0026plusmn; 5.66 years with a range between 20 and 39 years. Almost similar to the study carried out by \u003cstrong\u003eAksoy C \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[8]\u003c/sup\u003e\u003c/strong\u003e where the mean maternal age was 29.2 \u0026plusmn; 5.2 years. Additionally, \u003cstrong\u003eNadeem B\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[15]\u003c/sup\u003e\u003c/strong\u003e stated that the maternal age in their study had a range between 20 and 37 years with a mean age of 27.3 \u0026plusmn; 4.4 years. Also, the mean maternal age in a study carried out by \u003cstrong\u003eGarc\u0026iacute;a-Otero\u003c/strong\u003e \u003cstrong\u003eL\u003cem\u003e\u0026nbsp;et al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e was 32.5 \u0026plusmn; 5.0 years.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eApart from slight variances in the measurements as reported in the foregoing studies by \u003cstrong\u003eGarc\u0026iacute;a-Otero L \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e, \u003cstrong\u003eLussier EC\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[14]\u003c/sup\u003e\u003c/strong\u003e and \u003cstrong\u003eGu X \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[16]\u003c/sup\u003e\u003c/strong\u003e our study showed that all the measured fetal cardiac parameters increase steadily with the progress of gestation. These slight variations in the measurements might be attributable to the study population demographic differences, different study techniques used or sample size disparities.\u003c/p\u003e\n\u003cp\u003eIn agreement with \u003cstrong\u003eGarc\u0026iacute;a-Otero L\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e and \u003cstrong\u003e\u003cem\u003eGabbay-Benziv R\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;et al.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e[17]\u003c/sup\u003e\u003c/strong\u003e we found that both the left and right sides of heart are nearly equal in size at early weeks of gestation nevertheless with advance of pregnancy the right-side structures become slightly larger compared to the left side.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCardiac dimensions:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs per the\u0026nbsp;\u003cstrong\u003eGarc\u0026iacute;a-Otero L\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e proposal to measure the cardiac transverse diameter beneath the atrioventricular valves being the most accurate representation of the mid-cardiac length with the maximal possible transverse diameter we in our study thoroughly went along with such approach as our numbers manifested.\u003c/p\u003e\n\u003cp\u003eIn the current study, the fetal cardiac transverse and longitudinal diameters as well as areas references are mostly consistent with prior published data showing a progressive increase with advance in gestational age with mean value of cardiac transverse diameter increased from 16.58 \u0026plusmn; 0.38 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 40.34 \u0026plusmn; 1.86 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003eWhile the mean value of cardiac longitudinal diameter increased from 20.85 \u0026plusmn; 0.73 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 50.81 \u0026plusmn; 1.40 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation and the mean value of cardiac area increased from 267.90 \u0026plusmn; 15.53 mm\u003csup\u003e2\u003c/sup\u003e at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 1639.54 \u0026plusmn; 119.98 mm\u003csup\u003e2\u003c/sup\u003e at 38\u003csup\u003eth\u003c/sup\u003e week of gestation showing clear correlation with the results established by \u003cstrong\u003eLussier\u003c/strong\u003e \u003cstrong\u003eEC\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e[14]\u003c/sup\u003e\u003c/strong\u003e, \u003cstrong\u003eGarc\u0026iacute;a-Otero L\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u0026nbsp;\u003c/sup\u003e\u003c/strong\u003eand \u003cstrong\u003eLi\u003c/strong\u003e \u003cstrong\u003eX\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[18]\u003c/sup\u003e\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAtrial dimensions:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study results in the light of both atrial transverse and longitudinal dimensions besides the atrial areas are substantially in concurrence with previously published data by\u0026nbsp;\u003cstrong\u003eGarc\u0026iacute;a-Otero L\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eIn the current study, the estimated mean value of the left atrial transverse diameter increased from 6.53 \u0026plusmn; 0.56 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 16.64 \u0026plusmn; 1.10 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right atrial transverse diameter increased from 6.87 \u0026plusmn; 0.58 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 16.67 \u0026plusmn; 1.18 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003eWhereas the estimated mean value of the left atrial longitudinal diameter increased from 6.40 \u0026plusmn; 0.61 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 16.83 \u0026plusmn; 1.27 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right atrial longitudinal diameter increased from 6.32 \u0026plusmn; 0.55 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 16.64 \u0026plusmn; 1.15 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003eFurthermore, the mean value of the left atrial area increased from 38.79 \u0026plusmn; 6.52 mm\u003csup\u003e2\u003c/sup\u003e at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 224.13 \u0026plusmn; 37.05 mm\u003csup\u003e2\u003c/sup\u003e at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right atrial area increased from 38.91 \u0026plusmn; 6.18 mm\u003csup\u003e2\u003c/sup\u003e at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 228.34 \u0026plusmn; 36.41 mm\u003csup\u003e2\u003c/sup\u003e at 38\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eVentricular dimensions:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study results considering both ventricular transverse and longitudinal dimensions as well as the ventricular areas are mostly consistent with previously published data by\u0026nbsp;\u003cstrong\u003eGarc\u0026iacute;a-Otero L\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[11]\u003c/sup\u003e\u003c/strong\u003e. In the current study, the estimated mean value of the left ventricular transverse diameter increased from 5.77 \u0026plusmn; 0.62 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 14.78 \u0026plusmn; 1.52 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right ventricular transverse diameter increased from 5.85 \u0026plusmn; 0.67 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 15.08 \u0026plusmn; 1.30 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003eWhile the estimated mean value of the left ventricular longitudinal diameter increased from 12.10 \u0026plusmn; 1.12 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 26.97 \u0026plusmn; 2.63 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right ventricular longitudinal diameter increased from 10.62 \u0026plusmn; 1.25 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 27.07 \u0026plusmn; 2.40 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003eMoreover, the mean value of the left ventricular area increased from 65.71 \u0026plusmn; 13.01 mm\u003csup\u003e2\u003c/sup\u003e at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 357.52 \u0026plusmn; 71.23 mm\u003csup\u003e2\u003c/sup\u003e at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right ventricular area increased from 58.31 \u0026plusmn; 12.32 mm\u003csup\u003e2\u003c/sup\u003e at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 365.19 \u0026plusmn; 63.28 mm\u003csup\u003e2\u003c/sup\u003e at 38\u003csup\u003eth\u003c/sup\u003e week of gestation, similarly \u003cstrong\u003eGu X\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e[16]\u003c/sup\u003e\u003c/strong\u003e reported same results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eMyocardial wall thicknesses:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll our normal values of the right and left ventricular wall thicknesses as well as the interventricular septal wall thickness showed a progressive increase with advance in gestation.\u003c/p\u003e\n\u003cp\u003eThe current study results revealed that the mean left ventricular wall thickness value increased from 1.11 \u0026plusmn; 0.13 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 3.80 \u0026plusmn; 0.05 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the right ventricular wall thickness increased from 1.08 \u0026plusmn; 0.11 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 3.36 \u0026plusmn; 0.07 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation and the mean value of the thickness of interventricular septal wall increased from 1.05 \u0026plusmn; 0.09 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 3.45 \u0026plusmn; 0.09 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation. In concurrence with the prior results established by \u003cstrong\u003eGarc\u0026iacute;a-Otero L \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[19]\u003c/sup\u003e\u003c/strong\u003e, \u003cstrong\u003eDaimei T \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[20]\u003c/sup\u003e\u003c/strong\u003e as well as \u003cstrong\u003eRai P \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[21]\u003c/sup\u003e\u003c/strong\u003e who concluded that both left and right ventricular wall thicknesses increased from 2 mm at 21 week of gestational age reaching 5 mm at the 40\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePA, aorta diameters and the PA/Ao ratio:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn agreement with all prior studies, we observed that fetal pulmonary arterial diameter was always larger than aortic diameter. Moreover, both PA and aorta showed a progressively increased diameters throughout different gestational ages from 20 weeks till 38 weeks and were firmly correlated to the fetal age. Nevertheless, we found that the PA/Ao ratio was approximately constant across gestation. This agrees with \u003cstrong\u003eAksoy C \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[8]\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003ewho stated that the aorta and PA diameters increased with the advance of fetal gestational age between 20 and 24 weeks of gestation however the PA/Ao ratio remains constant. Also, \u003cstrong\u003eTayade\u003c/strong\u003e \u003cstrong\u003eAT\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e[22]\u0026nbsp;\u003c/sup\u003e\u003c/strong\u003estated that from 18 till 26 gestational ages in weeks the pulmonary arterial diameter enlarged with the progress of gestational age.\u003c/p\u003e\n\u003cp\u003eIn our study, the mean value of the fetal PA diameter increased from 3.20 \u0026plusmn; 0.18 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 8.02 \u0026plusmn; 0.11 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while for the aorta diameter increased from 2.78 \u0026plusmn; 0.15 mm at 20\u003csup\u003eth\u003c/sup\u003e week of gestation to 6.77 \u0026plusmn; 0.09 mm at 38\u003csup\u003eth\u003c/sup\u003e week of gestation while the PA/Ao ratio ranged between 1.118 and 1.190 with a mean of 1.166 \u0026plusmn; 0.012 and a mode of 1.155. This agrees with\u0026nbsp;\u003cstrong\u003eAksoy C et al. \u003csup\u003e[8]\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003ewho stated that the mean diameter of aorta was 3.70 \u0026plusmn; 0.54 mm, while the mean PA diameter was 4.28 \u0026plusmn; 0.51 mm. Furthermore, the PA/Ao ratio was 1.17 \u0026plusmn; 0.14 and the PA diameter was 12% larger than aorta diameter. Also, \u003cstrong\u003eNadeem B \u003cem\u003eet al.\u0026nbsp;\u003c/em\u003e\u003csup\u003e[15]\u0026nbsp;\u003c/sup\u003e\u003c/strong\u003estated that the average PA diameter ranged from 2.35 \u0026plusmn; 0.13 mm at 18 weeks of gestation to 3.60 \u0026plusmn; 0.19 mm at 26 weeks of gestation while the average diameter of Ao ranged from 1.56 \u0026plusmn; 0.45 mm at the 18\u003csup\u003eth\u003c/sup\u003e week of gestation up to 1.60 \u0026plusmn; 0.27 mm during the 26\u003csup\u003eth\u003c/sup\u003e week of gestation. Additionally, \u003cstrong\u003eTayade AT\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eet al.\u003c/em\u003e\u003c/strong\u003e \u003cstrong\u003e\u003csup\u003e[22]\u003c/sup\u003e\u003c/strong\u003e stated that the mean PA diameter was 3.37 \u0026plusmn; 0.66 mm with a diameter change from 2.48 \u0026plusmn; 0.27 mm during the 18\u003csup\u003eth\u003c/sup\u003e week of gestation till reaching 4.68 \u0026plusmn; 0.37 mm at the 26\u003csup\u003eth\u003c/sup\u003e week of gestation.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIt could be concluded that utilization of simple, easy and time saving ultrasound screening planes such as the four-chamber and three-vessel views during routine antenatal ultrasonographic examinations can enhance and boost the prenatal detection rate of CHD which in turn will be reflected as better newborn outcomes.\u003c/p\u003e\n\u003cp\u003eOur study has proposed reference ranges for twenty-one fetal normal cardiac parameters among the Egyptian population from the 20\u003csup\u003eth\u003c/sup\u003e to the 38\u003csup\u003eth\u003c/sup\u003e week of gestation which would facilitate detection of any deviation from normality as well as recognition of any undergoing cardiac morphology changes.\u003c/p\u003e\n\u003cp\u003eOur recommendations are to employ such handy, fast and non-invasive ultrasound scans during routine prenatal examination visits to assess the fetal heart morphology, detect any deviation from normality and enhance the detection rate of CHD prenatally. Moreover, conducting further studies with a large sample size from different demographic segmentations to prove our results is essential and recommended to develop more the references.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCHD: Congenital heart disease; GA: Gestational age; PA: Pulmonary artery; 3VV: Three-vessel view; Ao: Aorta; 4CV: Four-chamber view.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eOur current study was approved by the local ethical and scientific committee, faculty of Medicine, Menoufia university. All subjects were informed about the nature of the examination and signed consents were acquired.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eAll authors gave consent to publish the manuscript.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eAAZ contributed to the conception of the study, design of the study, acquisition and analysis of the data, interpretation of data, creation of the final work, study revision, and accuracy or integrity of the submitted manuscript. AMH contributed to the conception of the study, design of the study, acquisition and analysis of the data, interpretation of data, creation of the final work, study revision, and accuracy or integrity of the submitted manuscript. BSS contributed to the conception of the study, design of the study, acquisition and analysis of the data, interpretation of data, creation of the final work, study revision, and accuracy or integrity of the submitted manuscript. All authors have read and approved the manuscript.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eVan Nisselrooij AEL, Teunissen AKK, Clur SA, \u003cem\u003eet al.\u003c/em\u003e\u0026nbsp;(2020)Why are congenital heart defects being missed? \u003cem\u003eUltrasound Obstet Gynecol\u003c/em\u003e. 55(6):747-757.\u003c/li\u003e\n \u003cli\u003eRonai C, Freud LR, Brown DW, \u003cem\u003eet al.\u003c/em\u003e (2020)Low prenatal detection rate of valvar pulmonary stenosis: What are we missing? \u003cem\u003ePrenat Diagn\u003c/em\u003e. 40(8):966-971.\u003c/li\u003e\n \u003cli\u003eDudnikov O, Quinton A, Alphonse J. (2022)The detection rate of first trimester ultrasound in the diagnosis of congenital heart defects: A narrative review. \u003cem\u003eSonography\u003c/em\u003e. 8(2):36-42.\u003c/li\u003e\n \u003cli\u003eCharafeddine F, Hachem A, Kibbi N, \u003cem\u003eet al.\u003c/em\u003e (2019)The first fetal Echocardiography experience for Prenatal diagnosis of Congenital Heart Disease in Lebanon: Successes and challenges. \u003cem\u003eJ Saudi Heart Assoc\u003c/em\u003e. 31(3):125-129.\u003c/li\u003e\n \u003cli\u003eSriraam N, Prabha P. (2019)A Primitive Survey on Ultrasonic Imaging-Oriented Segmentation Techniques for Detection of Fetal Cardiac Chambers. \u003cem\u003eInt J Biomed Clin Eng\u003c/em\u003e. 8(2):69-79.\u003c/li\u003e\n \u003cli\u003eTanaka T, Inamura N, Kawazu Y, \u003cem\u003eet al.\u003c/em\u003e (2022)A rapid and Easy Objective Evaluation of the Three Vessel View to Enhance Diagnostic Confidence in Fetal Echocardiography. \u003cem\u003eJ Fetal Med\u003c/em\u003e. 9:1-5.\u003c/li\u003e\n \u003cli\u003eGuirado L, Crispi F, Masoller N, \u003cem\u003eet al.\u003c/em\u003e (2018)Biventricular impact of mild to moderate fetal pulmonary valve stenosis. \u003cem\u003eUltrasound Obstet Gynecol\u003c/em\u003e. 51(3):349-356.\u003c/li\u003e\n \u003cli\u003eAksoy C, Şimşek A, \u0026Ouml;zg\u0026uuml;r \u0026Ouml;, \u003cem\u003eet al.\u003c/em\u003e (2023)The reference diameters of the three great vessels in the fetuses between 20-24 weeks by sonography. \u003cem\u003eAkd Med J\u003c/em\u003e. 9(3):241-246.\u003c/li\u003e\n \u003cli\u003eCarvalho JS, Axt-Fliedner R, Chaoui R, \u003cem\u003eet al.\u003c/em\u003e (2023)ISUOG Practice Guidelines (updated): fetal cardiac screening. \u003cem\u003eUltrasound Obstet Gynecol\u003c/em\u003e. 61(6):788-803.\u003c/li\u003e\n \u003cli\u003eGudigar A, U R, Samanth J, \u003cem\u003eet al.\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(2022)Role of Four-Chamber Heart Ultrasound Images in Automatic Assessment of Fetal Heart: A Systematic Understanding. \u003cem\u003eInformatics\u003c/em\u003e. 9(2):34.\u003c/li\u003e\n \u003cli\u003eGarc\u0026iacute;a-Otero L, G\u0026oacute;mez O, Rodriguez-L\u0026oacute;pez M, \u003cem\u003eet al.\u003c/em\u003e (2020)Nomograms of Fetal Cardiac Dimensions at 18-41 Weeks of Gestation. \u003cem\u003eFetal Diagn Ther\u003c/em\u003e. 47(5):387-398.\u003c/li\u003e\n \u003cli\u003ePicazo-Angelin B, Zabala-Arg\u0026uuml;elles JI, Anderson RH, \u003cem\u003eet al.\u003c/em\u003e (2018)Anatomy of the normal fetal heart: The basis for understanding fetal echocardiography. \u003cem\u003eAnn Pediatr Cardiol\u003c/em\u003e. 11(2):164-173.\u003c/li\u003e\n \u003cli\u003eYetwale A, Kabeto T, Biyazin T, \u003cem\u003eet al.\u003c/em\u003e (2022)Prenatal Ultrasound Utilization and Its Associated Factors among Pregnant Women in Jimma Town Public Health Institutions, Ethiopia. \u003cem\u003eHealth Serv Res Manag Epidemiol\u003c/em\u003e. 9.\u003c/li\u003e\n \u003cli\u003eLussier EC, Yeh SJ, Chih WL, \u003cem\u003eet al.\u003c/em\u003e (2020)Reference ranges and Z-scores for fetal cardiac measurements from two-dimensional echocardiography in Asian population. \u003cem\u003ePLoS One\u003c/em\u003e. 15(6):e0233179.\u003c/li\u003e\n \u003cli\u003eNadeem B, Malik N, Niazi M, \u003cem\u003eet al.\u003c/em\u003e (2022)Establishing Normal Range of Fetal Pulmonary Artery and Fetal Aortic Diameter in 18\u0026ndash;26 Weeks of Gestation in Pakistani Population. \u003cem\u003ePakistan Journal of Medical \u0026amp; Health Sciences\u003c/em\u003e. 16(10):482.\u003c/li\u003e\n \u003cli\u003eGu X, He Y, Zhang Y, \u003cem\u003eet al.\u003c/em\u003e (2017)Fetal echocardiography: reference values for the Chinese population. \u003cem\u003eJ Perinat Med\u003c/em\u003e. 45(2):171-179.\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eGabbay-Benziv R, Turan OM, Harman C,\u003c/em\u003e \u003cem\u003eet al.\u003c/em\u003e (2015) Nomograms for Fetal Cardiac Ventricular Width and Right-to-Left Ventricular Ratio. \u003cem\u003eJ Ultrasound Med\u003c/em\u003e. 34(11):2049-2055.\u003c/li\u003e\n \u003cli\u003eLi X, Zhou Q, Huang H, \u003cem\u003eet al.\u003c/em\u003e (2015)Z-score reference ranges for normal fetal heart sizes throughout pregnancy derived from fetal echocardiography. \u003cem\u003ePrenat Diagn\u003c/em\u003e. 35(2):117-124.\u003c/li\u003e\n \u003cli\u003eGarc\u0026iacute;a-Otero L, Soveral I, Sep\u0026uacute;lveda-Mart\u0026iacute;nez \u0026Aacute;, \u003cem\u003eet al.\u003c/em\u003e\u0026nbsp;(2021)Reference ranges for fetal cardiac, ventricular and atrial relative size, sphericity, ventricular dominance, wall asymmetry and relative wall thickness from 18 to 41 gestational weeks. \u003cem\u003eUltrasound Obstet Gynecol\u003c/em\u003e. 58(3):388-397.\u003c/li\u003e\n \u003cli\u003eDaimei T, Damayanti N, Sinam V. (2014)Difference between the left and right ventricular thickness in fetal heart. \u003cem\u003eIOSR J Dent Med Sci\u003c/em\u003e. 13(4):21-24.\u003c/li\u003e\n \u003cli\u003eRai P, Bhushan R, Singh R. (2018)Assessment of Fetal Left and Right Ventricular Thickness and Its Comparison with Other Parameters: A Study of 20 Cases. J Med Sci Health 4(3):7-12.\u003c/li\u003e\n \u003cli\u003eTayade AT, Singh N, Kale SK, \u003cem\u003eet al.\u003c/em\u003e (2017)Nomogram of Fetal Pulmonary Artery Diameter in Second Trimester of Pregnancy. \u003cem\u003eInt J Sci Stud\u003c/em\u003e. 4(12):41-45.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Congenital heart disease (CHD), PA/Ao ratio, Four-chamber view (4CV), Pulmonary artery (PA), Three-vessel view (3VV), Aorta (Ao)","lastPublishedDoi":"10.21203/rs.3.rs-7068652/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7068652/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eCongenital heart disease (CHD) is a serious life-threatening medical condition in newborns with high rates of mortality. It is responsible for around fifty percent of total childhood deaths caused by birth defects so establishing the references for fetal normal cardiac morphometric parameters during various gestational ages is essential.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThe aim of the current study was to propose standard references for fetal normal heart dimensions, main pulmonary artery (PA) and aorta (Ao) diameters as well as the PA/Ao ratio across gestation in the Egyptian population to boost the detection rate of CHD before birth since early diagnosis of CHD has showed remarkably better outcomes.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eStandard references were established for twenty-one fetal normal cardiac morphometric measurements including PA and aorta diameters, PA/Ao ratio by the three-vessel view in addition to cardiac dimensions of the heart and each chamber separately as well as myocardial wall thicknesses by the four-chamber view. All estimated measurements showed a progressive increase throughout different gestational ages. Both sides of the heart were nearly equal in size at early weeks of gestation however with advance of gestation the right-side chambers became slightly larger than the left-side ones. The PA was regularly larger than the aorta with approximately constant PA/Ao ratio across gestation.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eDetection rate of CHD prenatally can be improved using simple screening methods during routine ultrasound scans. Our study has developed references for twenty-one cardiac parameters in normal local Egyptian fetuses from the 20th to the 38th week of gestation to enable early detection of any abnormal deviations.\u003c/p\u003e","manuscriptTitle":"Normal fetal cardiac morphometric parameters reference across gestation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-15 16:11:58","doi":"10.21203/rs.3.rs-7068652/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"afb9cecb-b314-4eab-9561-ded00ef8091c","owner":[],"postedDate":"October 15th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T16:02:14+00:00","versionOfRecord":{"articleIdentity":"rs-7068652","link":"https://doi.org/10.1186/s43055-025-01645-4","journal":{"identity":"egyptian-journal-of-radiology-and-nuclear-medicine","isVorOnly":false,"title":"Egyptian Journal of Radiology and Nuclear Medicine"},"publishedOn":"2025-12-03 15:57:51","publishedOnDateReadable":"December 3rd, 2025"},"versionCreatedAt":"2025-10-15 16:11:58","video":"","vorDoi":"10.1186/s43055-025-01645-4","vorDoiUrl":"https://doi.org/10.1186/s43055-025-01645-4","workflowStages":[]},"version":"v1","identity":"rs-7068652","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7068652","identity":"rs-7068652","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}