Document Detail

First-trimester fetal heart block: a marker for cardiac anomaly.
MedLine Citation:
PMID:  10623989     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fetal heart block in the second and third trimesters may be caused by transplacental passage of auto-antibodies or cardiac defects. Little is known about the etiology of first-trimester fetal heart block. MATERIALS AND METHODS: Fetal heart block was diagnosed in four patients (negative antibody serology) referred for first-trimester sonographic evaluation of increased fetal nuchal fold thickness with bradycardia. Two-dimensional echocardiography was complemented by color Doppler flow imaging of the fetal heart. Fetal arrhythmia was verified by M-mode, pulsed wave Doppler and/or color M-mode echocardiography. RESULTS: All fetuses had congenital heart disease, atrioventricular valve regurgitation, heart block and edema. Autopsy confirmed heterotaxy in three cases (left atrial isomerism with atrial septal defect; left isomerism with double-outlet right ventricle, great artery malposition and ventricular septal defect. The third case had dextrocardia with atrioventricular canal defect and the fourth case dextrocardia with great artery transposition. CONCLUSION: First-trimester fetal bradycardia may result from heart block of the type associated with complex congenital heart disease. Accelerated edema formation in this setting may be the basis of nuchal edema formation. First-trimester fetal echocardiography offers the potential for early diagnosis and intervention in these cases with poor prognosis.
A A Baschat; U Gembruch; G Knöpfle; M Hansmann
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  14     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  1999 Nov 
Date Detail:
Created Date:  2000-01-19     Completed Date:  2000-01-19     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  311-4     Citation Subset:  IM    
Center for Advanced Fetal Care, University of Maryland, Baltimore 21201-1703, USA.
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MeSH Terms
Fetal Heart / pathology,  ultrasonography*
Gestational Age
Heart Block / etiology,  pathology,  ultrasonography*
Heart Defects, Congenital / complications,  pathology,  ultrasonography*
Pregnancy Trimester, First
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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