Tetralogy of Fallot encompasses a range of congenital heart defects. The essential elements are a perimembraneous VSD with aortic over-ride and anterior deviation of the conal septum resulting in various degrees of pulmonary stenosis. The range in antenatal presentations of Tetralogy Of Fallot will be described, along with prognostic antenatal ultrasound features. Common non-cardiac associations will be covered as well as long term outcomes.

Introduction: For decades clinicians and researchers have independently assessed the fetal heart, fetal brain and placenta. However current literature shows that the effects of the placenta remain long beyond its separation at birth. Pregnancies with placental dysfunction can develop haemodynamic changes in the fetal heart and brain, additionally pregnancies with fetal congenital heart disease are at increased risk for brain and placental pathology. Understanding this relationship could aid in risk prediction for babies prior to birth with the use of ultrasound.
Methods: This talk will walk through what is unfolding in the current literature regarding this complex triad, as well current and future directions for clinical research and how ultrasound plays a significant role.
Results: A complex relationship occurs in utero between the placenta, fetal heart and fetal brain. Effects of the placenta remain long after birth, which is particularly evident in babies who were growth restricted.
Take home message: Sonography research is currently evolving to understand this relationship and identify babies who may be at most risk for poor outcomes.