Doppler study of the embryonic heart in normal pregnant women

Włoch, Agata; Rozmus-Warcholińska, Wioletta; Czuba, Bartosz; Borowski, Dariusz; Włoch, Stanisław; Cnota, Wojciech; Sodowski, Krzysztof; Szaflik, Krzysztof; Huhta, James C.

doi:10.1080/14767050701434747

Cited by 32 publications

(43 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Although the MPI has been assessed by many authors in the second and third trimesters, there is a paucity of data on the MPI in early pregnancy. 2 Assessment of fetal cardiac function has a role in determining normal physiologic characteristics and underlying pathophysiologic characteristics of fetal conditions. It may have a role in the first trimester in identifying fetuses at an increased risk of miscarriage, prediction of cardiac defects in fetuses with increased nuchal translucency, and also in early detection of the development of twin-to-twin transfusion syndrome in monochorionic twins.…”

Section: Abbreviationsmentioning

confidence: 99%

“…Those studies found that the proportion of the cardiac cycle occupied by both the isovolumetric relaxation time (IVRT) and isovolumetric contraction time (ICT) reduces during the first trimester. [2][3][4] The myocardial performance index (MPI) is a useful noninvasive Doppler-derived method of evaluating combined systolic and diastolic function, first described in …”

mentioning

confidence: 99%

See 1 more Smart Citation

First-Trimester Fetal Cardiac Function

Russell

McAuliffe

2008

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

Objective. The purpose of this study was to establish normal values for fetal heart function in the first trimester. Methods. This was a prospective observational study with institutional ethics approval and written maternal consent. Thirty-two healthy pregnant women were recruited, and transabdominal fetal echocardiography was performed between 12 and 14 completed weeks' gestation. Myocardial function was assessed with the myocardial performance index to assess combined systolic and diastolic function, isovolumetric contraction time to assess systolic function, and isovolumetric relaxation time to assess diastolic function. Mitral and tricuspid inflows were also assessed by determining the ratio between passive and active ventricular filling. The ventricular outflows were also assessed by peak systolic velocities (PSVs) and time velocity integrals (TVIs). Results. The mean gestational age at the time of echocardiography was 13 weeks, and the mean crown-rump length was 79 mm. All fetuses had a normal nuchal translucency measurement (mean, 1.5 mm). The myocardial performance index was the same in the left and right sides of the heart, 0.5. The mean isovolumetric relaxation time and isovolumetric contraction time on the left side of the heart were 41 and 36 milliseconds, respectively. The mean passive/active ventricular filling ratio was 0.6 at both the mitral and tricuspid valves. The mean aortic PSV was 26 cm/s, and mean pulmonary artery PSV was 32 cm/s. The mean aortic outflow TVI was 3.6 cm, and the mean pulmonary outflow TVI was 4.1 cm. Conclusions. This study establishes normal values for cardiac function at 12 to 14 weeks' gestation. These values may assist in assessment of fetal health in early pregnancy. Key words: cardiac function; echocardiography; fetus; first trimester; myocardial performance index. dvances in ultrasound technology have led to improved visualization of the fetus in the first trimester. This has led to increased interest in examining the fetus for abnormalities, with early fetal echocardiography now offered in many units. A recent article on early fetal echocardiography in firsttrimester fetuses found that a satisfactory cardiac examination was possible in 95% of cases, with sensitivity of 70% and specificity of 98% for detection of cardiac defects. 1 Assessment of cardiac function with Doppler examination of the atrioventricular (AV) valves has been performed in early pregnancy. Those studies found that the proportion of the cardiac cycle occupied by both the isovolumetric relaxation time (IVRT) and isovolumetric contraction time (ICT) reduces during the first trimester. [2][3][4] The myocardial performance index (MPI) is a useful noninvasive Doppler-derived method of evaluating combined systolic and diastolic function, first described in

show abstract

Section: Abbreviationsmentioning

confidence: 99%

mentioning

confidence: 99%

First-Trimester Fetal Cardiac Function

Russell

McAuliffe

2008

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…It should be noted that it is technically extremely difficult to obtain these tracings and, thus, very prolonged dwell times may be necessary. Some have described performing a measurement of the heart diameter, heart rate and inflow and outflow waveforms "after 5 weeks" [138]. No details are available on exposure levels.…”

Section: Is Doppler Different and Can It Have Detrimental Effects On mentioning

confidence: 99%

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

Abramowicz

2016

First-Trimester Ultrasound

View full text Add to dashboard Cite

1"Ultrasound is safe. Ultrasound is not X-rays. Our machines are FDA-approved." These are the statements most commonly made when initiating a conversation on safety of ultrasound. This is one of the reasons cited for its becoming an essential tool in medicine (together with its relatively low cost and immediate results availability). Diagnostic ultrasound (DUS) has been in use for over half a century in obstetrics and gynecology [1] and the benefits of this technology are multiple [2]. Most pregnant women have 2-3 ultrasound examinations (and many more in certain countries) during their pregnancies. In early pregnancy and before (i.e., in Artificial Reproductive Technologies [(ART]), these include serial scans of the developing follicles during ovulation induction [3] and in the earliest stages of gestation [4], first-trimester ultrasound for viability and/or aneuploidy screening (nuchal translucency, NT) and, more and more, early anatomy survey [5]. Such is the widespread enthusiasm and the generally accepted notion of safety that its use has spilled into the commercial world with mall stores offering non-medical ultrasound or "souvenir" scans. The record of safety of DUS is excellent: there are no epidemiological studies demonstrating harmful effects in human fetuses [6]. Most human epidemiological studies, however, published so far are based on information obtained with pre-1991/1992 machines. Around that time, the US Federal Drug Administration (FDA) allowed the acoustic output of ultrasound machines for fetal use to be increased from 94 to 720 mW/cm 2 , a factor of almost 8 [7,8]. Is there enough evidence to validate the use of ultrasound imaging in general and Doppler in particular in the first trimester [9] and could ultrasound have detrimental effects on the fetus in the first trimester, a time of maximal susceptibility to external factors? If there are clinical indications to perform these scans (and if there were none, there would be no raison-d'être for this book) safety must be guaranteed by educating the end-users on ways to limit the possible hazards of exposure of the follicles/ova and the fetus at early stages of gestation [2].

show abstract

“…Serial observations from the first and early second trimesters will provide further insight into the evolution of fetal cardiovascular disease during this period of very rapid fetal cardiovascular and general somatic growth. Already underway, first-trimester observations of fetal heart function may help us better to understand the role of myocardial function in the viability of pregnancies [85,86] In addition to first-trimester fetal echocardiography, the development of high resolution 3D and 4D fetal echocardiography will likely revolutionize prenatal detection through a reduction in scanning time, decrease in operator and window dependence, improved comprehension of the pathology and more accurate volumetric data [87].…”

Section: Evolving and Future Directions In Fetal Echocardiographymentioning

confidence: 99%

Fetal Echocardiography

Hornberger

2009

Echocardiography in Pediatric and Congenital Heart Disease

View full text Add to dashboard Cite

Doppler study of the embryonic heart in normal pregnant women

Cited by 32 publications

References 19 publications

First-Trimester Fetal Cardiac Function

First-Trimester Fetal Cardiac Function

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

Fetal Echocardiography

Contact Info

Product

Resources

About