Ultrasonographic diagnosis of delayed atrioventricular conduction during fetal life: a reliability study

Am J Obstet Gynecol. 2010 Aug;203(2):174.e1-7. doi: 10.1016/j.ajog.2010.02.024.

Abstract

Objective: The objective of the study was to evaluate the reliability of the 2 most commonly used ultrasonographic approaches for monitoring fetal atrioventricular conduction time (AVCT): (1) superior vena cava/ascending aorta (SVC/AA), and (2) left ventricular inflow/outflow tract (LVI/O) Doppler recordings.

Study design: Echographic studies from fetuses followed up for first-degree atrioventricular block (AVB-1) between 1998 and 2008 were reviewed. The ability to identify atrial contractions in the same fetuses by the SVC/AA and LVI/O approaches was analyzed.

Results: Sixty-six studies of 13 fetuses with AVB-1 were available. Atrial contractions were visible in all SVC/AA studies. With the LVI/O approach, atrial contractions could not be identified in 26 studies (39%). AVCT delay was significantly greater in the nonidentifiable compared with the identifiable atrial contraction group (P < .001). Differences in heart rate and gestational age were not significant.

Conclusion: The LVI/O is unsuitable for prenatal screening of conduction system anomalies.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aorta / diagnostic imaging
  • Atrioventricular Block / diagnostic imaging*
  • Atrioventricular Block / embryology
  • Cohort Studies
  • Echocardiography, Doppler / methods*
  • Electrocardiography
  • Female
  • Fetal Diseases / diagnostic imaging*
  • Fetal Monitoring / methods
  • Gestational Age
  • Heart Conduction System / diagnostic imaging
  • Heart Conduction System / embryology*
  • Heart Rate / physiology
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Myocardial Contraction / physiology
  • Pregnancy
  • Reproducibility of Results
  • Retrospective Studies
  • Ultrasonography, Prenatal*
  • Vena Cava, Superior / diagnostic imaging
  • Ventricular Outflow Obstruction / diagnostic imaging