Fetal tricuspid regurgitation

Česká verzia

Authors: J. Pavlíček ¹; T. Gruszka ¹; D. Matura ²; M. Pětroš ²; L. Jabůrek ³
Authors place of work: Oddělení dětské a prenatální kardiologie FN Ostrava, primář MUDr. T. Gruszka ¹; Porodnicko-gynekologická klinika FN Ostrava, přednosta MUDr. O. Šimetka, Ph. D. ²; Porodnicko-gynekologická klinika FN a LF UP Olomouc, přednosta doc. MUDr. R. Pilka, Ph. D. ³
Published in the journal: Ceska Gynekol 2011; 76(4): 306-315

Summary

Aims:
To study the incidence and significance of fetal tricuspid insufficiency (TI). Evaluation of this incidence of physiological fetuses and of fetuses with congenital heart defects (CHDs). Possibility of prediction the other significant heart pathology or pathology of fetal circulation of fetuses with tricuspid regurgitation (TR).

Methodology:
The study was undertaken between June 2006 and 2010. Fetal echocardiography in the Moravian-Silesian region was mostly performed as a primary screening in the second term of pregnancy. The diameters of the right side of the heart (tricuspid valve annulus, pulmonary valve annulus, surface of the right atrium and diastolic size of the right ventricle) of fetuses with and without TI were evaluated. The pathology of the pregnancy was generally examined and delivery of the newborn was planned. The fetuses with TI were monitored and examined after delivery.

Results:
In the observed period, 8 896 pregnancies were examined and we diagnosed 90 significant CHDs. TR occurred in 178 (2%) fetuses. Out of them 20 (11%) fetuses had a defined CHD or significant heart arrhythmia. The most critical CHD with TR was hypoplastic left heart syndrome. TI was insignificant in 158 (89%) fetuses. Progression of the significance of TR with the color Doppler mapping correlated with increased speed of flow. The parameters of the right side of the heart of fetuses with TI do not significantly differ from that of fetuses with a normal tricuspid valve. After the delivery of fetuses with TI, no CHD or chromosomal aberrations were confirmed.

Conclusions:
The detection of fetal TI during pregnancy is possible. In some fetuses, there is TI connected with some other CHDs which might be detected by fetal echocardiography what provides us detailed description and diagnosis. TI was always insignificant after a CHD had been eliminated and this TR in the fetus did not significantly affect haemodynamics and did not predict any pathology.

Key words:
congenital heart defect, fetal echocardiography, tricuspid regurgitation.

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