Fetal Doppler mechanical PR interval: correlation with fetal heart rate, gestational age and fetal sex. 2009

A Wojakowski, and G Izbizky, and M E Carcano, and H Aiello, and P Marantz, and L Otaño
Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

OBJECTIVE To establish normal fetal values for the mechanical PR interval by pulsed-wave Doppler at 16-36 weeks of gestation, and to evaluate the influence of fetal heart rate (FHR), gestational age (GA) and fetal sex. METHODS Fetal mechanical PR intervals were evaluated prospectively by obstetric ultrasound examination. Healthy mothers with sonographically normal fetuses from singleton pregnancies were included. Mechanical PR intervals were measured from simultaneous mitral and aortic Doppler waveforms, from the onset of left atrial contraction (mitral A-wave) to the onset of left ventricular ejection (aortic pulse wave). Simple and multiple linear regression analyses were performed to examine the correlation between PR interval and GA, FHR and fetal sex. RESULTS We evaluated 336 fetuses at 16-36 weeks. The mean +/- SD FHR was 143.4 +/- 8.3 beats per min (bpm). The PR intervals had a typical Gaussian distribution with a mean +/- SD of 122.4 +/- 10.3 ms. Robust linear regression showed that the PR increased by about 0.40 ms (95% CI, 0.22-0.58) per gestational week (P < 0.001), and this relationship remained after adjustment for FHR and fetal sex. PR intervals diminished by 1.4 (95% CI, 0.75 to 2.0) ms for each 5 bpm increase in FHR (P < 0.001), independently of GA and fetal sex. No fetal sex differences were observed. CONCLUSIONS We provide normal fetal values for the mechanical PR interval at 16-36 weeks of gestation. Mechanical PR intervals in normal fetuses are influenced by GA and FHR independently, and both variables should be taken into account when evaluating fetuses at risk for congenital heart block.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D005260 Female Females
D005318 Fetal Heart The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (HEART/embryology) only on the basis of time. Fetal Hearts,Heart, Fetal,Hearts, Fetal
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006329 Heart Conduction System An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart. Conduction System, Heart,Conduction Systems, Heart,Heart Conduction Systems,System, Heart Conduction,Systems, Heart Conduction
D006340 Heart Rate, Fetal The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute. Fetal Heart Rate,Fetal Heart Rates,Heart Rates, Fetal,Rate, Fetal Heart,Rates, Fetal Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012737 Sex Factors Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances. Factor, Sex,Factors, Sex,Sex Factor

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