5. Conclusions
Between both operators, our data indicated that 2D-STE analysis showed excellent agreement for cardiac morphometry parameters (ED (ventricular size) and SI (ventricular shape)), and good agreement for cardiac function parameters (EndoGLS and FS (ventricular contractility)). For less experienced operators to benefit from this state-of-the-art technology, a number of obstacles obviously still need to be overcome. With knowledge of these pitfalls, the 2D-STE analysis method can be learned efficiently and performed with a high level of expertise. However, as long as the performance of a 2D-STE analysis will not be completely standardized and automated, we cannot recommend its use in clinical routine for comprehensive fetal cardiac functional analysis by less experienced operators ‘on-the-fly’, despite good to excellent agreement of global and segmental deformation parameters between both operators. AI will facilitate the implementation of 2D-STE analysis in daily clinical practice. At present, from our perspective, due to its complexity, the application of fetal 2D-STE remains the domain of scientific-academic ultrasound perinatal diagnostics and should be placed preferably in the hands of skilled operators.