Fetal Echo Views
13-view sweep sequence
1
Abdominal Situs View
SitusThe first step in fetal cardiac evaluation. Confirms normal situs solitus — stomach on left, liver on right, aorta left of spine, IVC right of spine. Situs abnormalities are strongly associated with complex congenital heart disease.
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Anatomy Diagram
Clinical Echo Image
Structures to Identify
- Stomach (left)
- Liver (right)
- Descending aorta (left of spine)
- IVC (right of spine)
- Umbilical vein
- Spine (posterior)
Normal Findings
- Stomach bubble on LEFT side of fetus
- Aorta to LEFT of spine, IVC to RIGHT
- Liver on right, stomach on left
- Umbilical vein entering liver anteriorly
Scanning Technique
Transverse view of fetal abdomen at level of stomach. Identify spine posteriorly. Confirm stomach on left and aorta/IVC positions relative to spine.
Patient Positioning
Mother supine or left lateral tilt; obtain true transverse cardiac cut perpendicular to fetal spine
Doppler
Color Doppler to confirm aorta (pulsatile) vs. IVC (venous) positions relative to spine.
Common Pitfalls
- Fetal position may make left/right orientation confusing — always reference spine first
- Absent stomach may indicate esophageal atresia or diaphragmatic hernia
Red Flags / Abnormal Findings
- !Stomach on RIGHT (situs inversus or heterotaxy)
- !Stomach absent (esophageal atresia, CDH)
- !Aorta and IVC on same side (asplenia/polysplenia)
- !Midline stomach (heterotaxy)
Clinical images © All About Ultrasound, Inc. / iHeartEcho™. Educational use only.