The origin of ICEF remains unclear. It is considered a normal developmental variant, but either inflammatory or hypoxic processes could be involved in its appearance. In low-risk populations for aneuploidy, the presence of an ICEF is not an indication for invasive procedures. In high-risk populations this depends on the previous calculated risk. In euploid fetuses, cardiac function is not significantly altered but further studies in specific populations may be justified. Fetuses with diffuse myocardial calcification or multiple foci may need further investigations.
Objective Previous studies have suggested that antiretroviral therapy in human immunodeficiency virus (HIV)-infected pregnant women can cause alterations in cardiac structure and function in fetuses or children, although the results are not very clear. The aim of this study is to assess whether or not these alterations are present in the heart of fetuses of HIV-infected pregnant women, undergoing treatment with highly active antiretroviral therapy (HAART).Study Design We performed a prospective study on 29 consecutive HIV-positive pregnant women treated with HAART and 70 consecutive HIV-negative pregnant women as controls. Fetal cardiac biometry and function was evaluated by echocardiography at 30-32 weeks of gestation. Fetal biometry, estimated fetal weight and umbilical artery Doppler were also measured.
ResultsWe found E/A tricuspid ratio values slightly increased (0.84 vs 0.80, p = 0.03) and diastolic length shortened (49.7 vs 51.7%, p = 0.03) in the HIV-infected group. The rest of the biometric and functional cardiac parameters were not different between both groups. There were no cases of vertical transmission of HIV infection.
ConclusionIn HIV-infected pregnant women treated with HAART, no significant changes are showed in fetal cardiac parameters.
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