Accurate identification of CHD during early pregnancy remains a major clinical challenge, and multiparameter Doppler assessment may address this gap. These findings were presented at the American Heart Association (AHA) 2025 Scientific Sessions.

This observational study evaluated 2,529 fetuses with normal cardiac findings and 50 fetuses with CHD assessed between 11+0 and 16+0 weeks of gestation at two maternal and child health centers. Color Doppler ultrasonography assessed ventricular septal angle (VSA), cardiothoracic ratio (CTR), global spherical index (GSI), and cardiac axis (CAx). Associations between these parameters and gestational age (GA) were analyzed, and Z-score reference ranges were constructed and validated.

VSA showed a negative correlation with GA, while CTR and GSI demonstrated positive correlations. CAx showed no significant correlation with GA. A polynomial linear regression model incorporating all four parameters significantly improved CHD detection compared with monomial regression models based on single parameters.

Across CHD subtypes, VSA, CTR, GSI, and CAx demonstrated statistically significant differences in abnormal and critical CHD, supporting their role as effective early-pregnancy screening markers. The combined model showed superior diagnostic performance compared with individual parameter assessment.

These findings indicate that combined early-pregnancy Doppler ultrasound parameters provide quantitative support for improved CHD screening, with particular value in identifying abnormal and critical disease forms.