ultrasound diagnosis of fatal anomalies

THE HEART
Fig. 5.9 Atrioventricular septal defect. Demonstration
of blood flow over the defective AV valve
using color flow mapping as well as pulsed Doppler
sonography.
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References
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First-trimester diagnosis of fetal congenital heart
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Moss and Adams heart disease in infants, child-
Bradycardia
Definition: Heart frequency below 100 beats per
minute.
Incidence: One in 20 000 births.
Clinical history/genetics: 50% of cases are due to
a complete AV block resulting from an autoimmune
disease. The rate of recurrence is 8% if one
child is affected.
Teratogens: Not known.
Embryology: Autoantibodies can disturb the
cardiac stimulus conduction system. If structural
ren, and adolescents, including the fetus and young
adult. Baltimore: Williams & Wilkins, 1995: 704–24.
Murphy DJ Jr. Atrioventricular canal defects. Curr Treat
Options Cardiovasc Med 1999; 1: 323–34.
Paladini D, Calabrb R, Palmieri S, Dandrea T. Prenatal diagnosis
of congenital heart disease and fetal karyotyping.
Obstet Gynecol 1993; 81: 679–82.
Park JK, Taylor DK, Skeels M, Towner DR. Dilated coronary
sinus in the fetus: misinterpretation as an atrioventricular
canal defect. Ultrasound Obstet Gynecol
1997; 10: 126–9.
Stoll C, Dott B, Alembik Y, Roth MP. Evaluation of routine
prenatal ultrasound examination in detecting fetal
chromosomal abnormalities in a low risk population.
Hum Genet 1993; 91: 37–41.
Tennstedt C, Chaoui R, Korner H, Dietel M. Spectrum of
congenital heart defects and extracardiac malformations
associated with chromosomal abnormalities:
results of a seven year necropsy study. Heart 1999;
82: 34–9.
malformation is the cause, then the atrioventricular
septum is mostly involved.
Associated malformations: In 50% of cases, complex
cardiac anomalies are present such as AV
canal, VSD, atrial isomerism, or abnormal
venous flow. Fetal hydrops must be excluded. If
there is sinus bradycardia, malformation of the
central nervous system and fetal growth restriction
should be looked for.
Ultrasound findings: A very slow heartbeat is the
first sign detected in B-mode. M-mode echocardiography
is needed for further differentiation.
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