M-mode echocardiographic evaluation of fetal and infant hearts: longitudinal follow-up study from intrauterine life to year one

Am J Obstet Gynecol. 1996 Oct;175(4 Pt 1):922-8. doi: 10.1016/s0002-9378(96)80026-3.


Objective: Our purpose was to evaluate cardiac variables, including right and left end-diastolic and end-systolic dimensions by use of M-mode echocardiography during fetal, neonatal (transitional), and infancy periods to understand hemodynamic adaptation during these periods.

Study design: Fifty-three fetuses were enrolled in this study. Echocardiography evaluations were started as early as the sixteenth week of gestation and were repeated every 4 to 6 weeks until term, on postnatal days 1 and 2, and at 6 weeks, 6 months, and 12 months of age. End-diastolic and end-systolic measurements were made according to published standards. Mean and SEM for each of the end-diastolic and end-systolic measurements were calculated for each of 11 study periods. Data were analyzed by one-way analysis of variance, corrected for repeated measures, and in the case of right and left ventricular differences paired t tests were used for significance.

Results: Left ventricular end-diastolic and end-systolic correlated positively with advancing age (R2 = 0.93, p < 0.0001), right ventricular end-diastolic also correlated with advancing age (R2 = = 0.361, p < 0.05), and right ventricular end-diastolic was significantly larger than left ventricular end-diastolic in utero (p < 0.01), whereas the opposite was true after birth (p < 0.0001). Heart rate significantly decreased with advancing age (p < 0.001), whereas ejection fraction for either the right or the left ventricle did not change significantly with advancing age.

Conclusion: This suggests that under basal conditions the ventricles can meet the increased demands in cardiac output by increasing ventricular dimensions without having to increase contractility reserve.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child Development*
  • Diastole
  • Echocardiography*
  • Embryonic and Fetal Development*
  • Female
  • Follow-Up Studies
  • Heart Rate
  • Heart Septum / diagnostic imaging
  • Heart Septum / embryology
  • Heart Septum / physiology
  • Heart Ventricles
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Pregnancy
  • Pregnancy Outcome
  • Stroke Volume
  • Systole
  • Ultrasonography, Prenatal*