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Common Findings in Late‐Gestation Fetal Echocardiography
Author(s) -
Tague Lauren,
Donofrio Mary T.,
Fulgium Amanda,
McCarter Robert,
Limperopoulos Catherine,
Schidlow David N.
Publication year - 2017
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14283
Subject(s) - medicine , ductus arteriosus , cardiology , tricuspid valve , fetal echocardiography , fetus , atrioventricular valve , gestational age , gestation , regurgitation (circulation) , diastole , pregnancy , ventricle , prenatal diagnosis , blood pressure , biology , genetics
Objectives Fetal echocardiography provides detailed information about cardiac structure and function in utero. Limited information is available regarding normal findings late in pregnancy. We therefore sought to identify and describe common cardiac findings in late gestation. Methods Fetuses with structurally normal hearts were identified in mid gestation within a subset of pregnant women in a prospective study. The atrioventricular valves, right and left atria, aortic isthmus and ductus arteriosus dimensions and flow abnormalities, aneurysm of the septum primum, and presence and grade of tricuspid regurgitation were assessed throughout pregnancy. Linear and logistic regression analyses were used to characterize changes in quantitative and qualitative fetal echocardiographic parameters by gestational age (GA). Results Forty fetuses between 24 and 38 weeks' GA were studied. Each had a fetal echocardiographic study completed before and after 34 weeks' gestation, which were compared. Tricuspid‐to‐mitral valve and right‐to‐left atrium ratios increased with GA ( P < .001). More frequently noted after 34 weeks were tapering of the ductus arteriosus (2.5% versus 32%), prominent aortic isthmus diastolic flow (5% versus 67%), prominent ductus arteriosus diastolic flow (2.5% versus 25%), trivial or mild tricuspid regurgitation (35% versus 80%), and aneurysms of the septum primum (37.5% versus 80%). These findings all increased linearly with GA ( P < .001). Conclusions Atrioventricular valve and right/left atrium disproportion, mild ductus arteriosus tapering, prominent aortic isthmus and ductus arteriosus diastolic flow, trivial or mild tricuspid regurgitation, and aneurysms of the septum primum are frequently identified after 34 weeks' GA. Their identification suggests that these fetal echocardiographic findings in isolation are likely normal and are results of the physiologic alterations that occur late in the third trimester.