Quick TiPs - Determining Situs in Fetal EchoCardiography

What is the arrow in the image referencing? You guessed it! The Stomach Position – Key to Determining Situs. Let’s talk about why.

When assessing situs in fetal echocardiography, one of the first steps is identifying the location of the fetal stomach. The stomach normally sits on the left side of the fetus (situs solitus). If it’s seen on the right, this suggests situs inversus or heterotaxy, depending on other organ positions.
By combining the stomach position with the heart apex direction and aortic/IVC arrangement, sonographers can confidently determine situs:

• Situs Solitus: Stomach and heart apex both on the left.
• Situs Inversus: Stomach and heart apex both on the right.
• Heterotaxy: Discordant or midline arrangement of abdominal and thoracic organs.

This step is fundamental because situs determination sets the framework for identifying congenital heart disease. Just like recognizing a zero Doppler shift depends on angle, situs depends on orientation landmarks—the stomach is your starting point!

Want to learn more about determining situs? Sign up for our FREE CME course and get 1 SDMS CME Credit for free!

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