Society of Diagnostic Medical Sonography

This session presents streamlined methods for evaluating fetal cardiac anatomy and function across all trimesters during routine obstetric ultrasound. Attendees will review key sonographic indicators of normal and abnormal cardiac structure, including situs, chamber size and proportion, rhythm, and motion. The session aims to build confidence in recognizing normal patterns and identifying fetuses at risk for structural heart disease or early signs of heart failure.

• Describe key fetal cardiac parameters—such as situs, position, chamber proportions, rhythm, and vessel relationships—used in functional and structural heart assessments.
• Recognize sonographic patterns that differentiate normal from abnormal fetal cardiac anatomy at various gestational ages.
• Identify fetuses at risk for congenital heart disease or congestive heart failure based on cardiac shape and motion patterns.

Screening evaluations of the fetal heart can be intimidating and technically challenging to both learn and perform, yet they are essential for the early detection of congenital heart defects. The three-vessel view (3VV) and three-vessel tracheal view (3VTV) are now part of the standardized fetal heart screening protocol, but remain relatively new in educational curricula and are often misunderstood in clinical practice. This session introduces a memorable and innovative mnemonic, the “Snowman on a Sled,” to improve sonographers’ understanding and acquisition of these views. Attendees will learn how this analogy enhances recognition of both normal and abnormal cardiac anatomy.

• Review the structure and function of the fetal heart and define the standard screening views.
• Examine the clinical value and diagnostic utility of the 3VV and 3VTV views in fetal heart screening.
• Apply the “Snowman on a Sled” analogy to identify normal anatomy and congenital heart defects.