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Fetal Right Heart Enlargement

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    CME Credit Information

    Credit Type
    AMA PRA Category 1 *
    Number of Credits

    Course Objectives

    After completing this course, the participant should be able to:

    PART 1

    1. Describe the 3 congenital tricuspid valve defects resulting in right heart dilation in the fetus and how to differentiate them on fetal echo.

    2. Name 2 associated findings with Ebstein’s anomaly and the arrhythmias they can cause.

    3. Explain reasons for the poor prognosis for severe tricuspid insufficiency in the fetus.

    PART 2

    1. List the 4 causes of right heart dilation in the fetus with a structurally normal tricuspid valve

    2. Describe the features of premature ductal constriction

    3. Describe the etiologies and management of ductal constriction

    4. Describe the features of right heart failure in the fetus.

    5. Differentiate valvar pulmonary stenosis from absent pulmonary valve syndrome 

    PART 3

    1. Describe the diagnostic approach to differentiate coarctation of the aorta from other defects causing right heart enlargement

    2. Explain why growth restriction results in right heart enlargement

    3. Explain the etiology of twin to twin transfusion syndrome (TTTS)

    4. Summarize the cardiac findings seen with Vein of Galen aneurysms

    Target Audience

    Physicians, sonographers and others who perform and/or interpret obstetrical ultrasound.

    * AMA Category 1 credits are used by physicians and other groups like PAs and certain nurses.  Category 1 credits are accepted by the ARDMS, CCI and Sonography Canada.


    The Institute for Advanced Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    The Institute for Advanced Medical Education designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

    These credits are accepted by the American Registry for Diagnostic Medical Sonography (ARDMS).

    For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board or other credentialing organization.

    Estimated Time for Completion
    approximately 50 minutes
    Date of Release
    Date of Most Recent Review
    Expiration Date


    Bettina Cuneo, MD
    Director of Perinatal Cardiology and Fetal Cardiac Telemedicine
    Professor of Pediatrics and Obstetrics
    Children’s Hospital of Colorado


    In compliance with the Essentials and Standards of the ACCME, the author of this CME tutorial is required to disclose any significant financial or other relationships they may have with commercial interests.

    Dr. Bettina Cuneo discloses no such relationships exist.

    No one at IAME who had control over the planning or content of this activity has relationships with commercial interests.

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    Michelle M. Woods RDMS, RVT, Hanover, Mass.