Abstract
Atrioventricular valve insufficiency (AVVI) has been suggested as a cause for nonimmune hydrops in utero. Pulsed 2-D-directed Doppler echocardiography was utilized for the detection of AVVI in 41 fetuses ranging in gestational age from 16-39 weeks. AVVI was diagnosed by a systolic velocity in either atria of greater than 1 meter per second.
AVVI was present in 5/41 fetuses (12%) and confirmed after birth in 3/3. Of 22 fetuses at risk for congenital heart disease but found to be normal, one had AVVI (5%). Of 11 patients with fetal dysrhythmia, 2/2 with complete heart block (1 normal and 1 with AV canal) had intermittent AVVI, and 7 with premature atrial contractions and 2 with atrial tachycardia had none. Of 6 patients with abnormal cardiac findings, 2 had AVVI (1 with endocardial fibroelastosis and bilateral AVVI, and 1 with cerebral arteriovenous malformation) while there was no AVVI in 4 patients with VSD including 1 with hydrops. Two patients with a normal heart and hydrops had no AVVI.
Conclusions: (1) AVVI occurs in utero and may be diagnosed by pulsed Doppler echocardiography. (2) AVVI may be present in normals, in fetuses with congenital heart block with or without heart disease, and is not present in all forms of nonimmune hydrops fetalis.
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Huhta, J., Murphy, D., Carpenter, R. et al. 107 PULSED DOPPLER DIAGNOSIS OF ATRIOVENTRICULAR VALVE INSUFFICIENCY IN UTERO. Pediatr Res 19, 128 (1985). https://doi.org/10.1203/00006450-198504000-00137
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DOI: https://doi.org/10.1203/00006450-198504000-00137