Background To investigate the structure of the ex-vivo fetal heart a high-quality imaging modality is vital because its size, especially in early gestation, is too small to manipulate by hand. High resolution episcopic microscopy (HREM) is a new method for high-quality 3D reconstruction of fetal specimens. 3D images are created by the automatic capturing of over 1000 perfectly aligned tomographic slices. We report the preliminary results of HREM in human fetal hearts.
Methods Following ethical approval, we collected heart tissue from singleton pregnancies who underwent surgical termination of pregnancy from 6 to 18 weeks. The hearts were embedded into plastic resin before automatic sectioning and digital capturing to create 3D images.
Results We retrieved 36 fetal hearts (9–17 weeks of postmenstrual gestation) from 120 attempted collections. Twelve samples have been processed so far. It has been possible to create high-quality 3D images of the fetal heart (figs 1 and 2). There were four morphological features characteristic of first/early second trimester human heart compared with the mouse or later human hearts. The atrial appendages are more prominent and the great arterial walls are thickened compared with the second trimester human heart. The ventricular arrangement is more spiral and coronary arteries are more prominent in the human compared with the same stage of the mouse heart.
Conclusions HREM can produce detailed morphological 3D images of the human fetal heart in the first trimester. This technique may be useful in the assessment of hearts that develop abnormally during the maturation phase such as hypoplastic left or right heart syndrome.
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