First-trimester fetal heart block: A marker for cardiac anomaly

Ahmet Baschat, U. Gembruch, G. Knöpfle, M. Hansmann

Research output: Contribution to journalArticle

Abstract

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 brachycardia 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.

Original languageEnglish (US)
Pages (from-to)311-314
Number of pages4
JournalUltrasound in Obstetrics and Gynecology
Volume14
Issue number5
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Fetal Heart
Heart Block
First Pregnancy Trimester
markers
echocardiography
edema
anomalies
Dextrocardia
heart diseases
Echocardiography
Edema
defects
arteries
antibodies
bradycardia
Color
heart valves
Heterotaxy Syndrome
Double Outlet Right Ventricle
Isomerism

Keywords

  • Cardiac anomaly
  • First trimester
  • Heart block
  • Nuchal edema
  • Ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Acoustics and Ultrasonics

Cite this

First-trimester fetal heart block : A marker for cardiac anomaly. / Baschat, Ahmet; Gembruch, U.; Knöpfle, G.; Hansmann, M.

In: Ultrasound in Obstetrics and Gynecology, Vol. 14, No. 5, 1999, p. 311-314.

Research output: Contribution to journalArticle

Baschat, Ahmet ; Gembruch, U. ; Knöpfle, G. ; Hansmann, M. / First-trimester fetal heart block : A marker for cardiac anomaly. In: Ultrasound in Obstetrics and Gynecology. 1999 ; Vol. 14, No. 5. pp. 311-314.
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